Effects of preventive home visits on older people's use and costs of health care services : A systematic review

Peer reviewe

Preventive home visits to promote the health-related quality of life of home-dwelling older people : Baseline findings and feasibility of a randomized, controlled trial

Background and aims: Studies on multiprofessional preventive home visits to older people are needed. We describe here the baseline findings and feasibility of a randomized controlled study on preventive home visits delivered by a multiprofessional team. Materials and methods: Participants (n = 422) were home-dwelling people who were 75+ years old. They were recruited from the Hyvinkaaa municipal area. They were randomized into intervention and control groups. Participants in the intervention group received three home visits, delivered by a nurse, physiotherapist and social worker. Health-related quality of life (HRQoL), measured by 15D, was used as our primary outcome measurement. Feedback on the intervention was gathered from the participants. Results: The mean age of our participants was 81 years. They scored 0.82 in the 15D HRQoL score, and 65% were female. The findings of both groups were similar in most background variables. The only differences between the groups were that lower proportions of participants in the intervention group had diabetes or used a walker. The professionals delivering the intervention reported that all intervention procedures had been delivered according to plan. Participants who responded to the feedback survey mostly reported having gained new information and were fairly content with the intervention. However, most participants felt the home visits had not improved their health or functioning. Conclusions: We have successfully randomized participants into two study groups in this trial examining the effectiveness of preventive home visits. The intervention seems feasible and has mostly been well received. (C) 2017 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.Peer reviewe

Feature-Specific Information Processing Precedes Concerted Activation in Human Visual Cortex

Current knowledge about the precise timing of visual input to the cortex relies largely on spike timings in monkeys and evoked-response latencies in humans. However, quantifying the activation onset does not unambiguously describe the timing of stimulus-feature-specific information processing. Here, we investigated the information content of the early human visual cortical activity by decoding low-level visual features from single-trial magnetoencephalographic (MEG) responses. MEG was measured from nine healthy subjects as they viewed annular sinusoidal gratings (spanning the visual field from 2 to 10° for a duration of 1 s), characterized by spatial frequency (0.33 cycles/degree or 1.33 cycles/degree) and orientation (45° or 135°); gratings were either static or rotated clockwise or anticlockwise from 0 to 180°. Time-resolved classifiers using a 20 ms moving window exceeded chance level at 51 ms (the later edge of the window) for spatial frequency, 65 ms for orientation, and 98 ms for rotation direction. Decoding accuracies of spatial frequency and orientation peaked at 70 and 90 ms, respectively, coinciding with the peaks of the onset evoked responses. Within-subject time-insensitive pattern classifiers decoded spatial frequency and orientation simultaneously (mean accuracy 64%, chance 25%) and rotation direction (mean 82%, chance 50%). Classifiers trained on data from other subjects decoded the spatial frequency (73%), but not the orientation, nor the rotation direction. Our results indicate that unaveraged brain responses contain decodable information about low-level visual features already at the time of the earliest cortical evoked responses, and that representations of spatial frequency are highly robust across individuals.Peer reviewe

Non-linear dynamical analysis of resting tremor for demand-driven deep brain stimulation.

Parkinson's Disease (PD) is currently the second most common neurodegenerative disease. One of the most characteristic symptoms of PD is resting tremor. Local Field Potentials (LFPs) have been widely studied to investigate deviations from the typical patterns of healthy brain activity. However, the inherent dynamics of the Sub-Thalamic Nucleus (STN) LFPs and their spatiotemporal dynamics have not been well characterized. In this work, we study the non-linear dynamical behaviour of STN-LFPs of Parkinsonian patients using ε -recurrence networks. RNs are a non-linear analysis tool that encodes the geometric information of the underlying system, which can be characterised (for example, using graph theoretical measures) to extract information on the geometric properties of the attractor. Results show that the activity of the STN becomes more non-linear during the tremor episodes and that ε -recurrence network analysis is a suitable method to distinguish the transitions between movement conditions, anticipating the onset of the tremor, with the potential for application in a demand-driven deep brain stimulation system

Effect of long-term paired associative stimulation on the modulation of cortical sensorimotor oscillations after spinal cord injury

Study design A prospective interventional case series. Objectives To explore changes in the modulation of cortical sensorimotor oscillations after long-term paired associative stimulation (PAS) in participants with spinal cord injury (SCI). Setting BioMag Laboratory, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Methods Five patients with chronic incomplete SCI received unilateral spinal PAS to upper limb for 16-22 days. Changes in the modulation of sensorimotor oscillations in response to tactile stimulus and active and imaginary hand movements were assessed with magnetoencephalography recorded before and after the intervention. Results PAS restored the modulation of sensorimotor oscillations in response to active hand movement in four patients, whereas the modulation following tactile stimulation remained unaltered. The observed change was larger in the hemisphere that received PAS and preceded the clinical effect of the intervention. Conclusions Long-term spinal PAS treatment, which enhances the motor functions of SCI patients, also restores the modulation of cortical sensorimotor oscillations.Peer reviewe

The Lagrange and Markov spectra from the dynamical point of view

This text grew out of my lecture notes for a 4-hours minicourse delivered on October 17 \& 19, 2016 during the research school "Applications of Ergodic Theory in Number Theory" -- an activity related to the Jean-Molet Chair project of Mariusz Lema\'nczyk and S\'ebastien Ferenczi -- realized at CIRM, Marseille, France. The subject of this text is the same of my minicourse, namely, the structure of the so-called Lagrange and Markov spectra (with an special emphasis on a recent theorem of C. G. Moreira).Comment: 27 pages, 6 figures. Survey articl

Update of the Minimum Information About BIobank Data Sharing (MIABIS) Core Terminology to the 3^rd Version

Introduction: The Minimum Information About BIobank Data Sharing (MIABIS) is a biobank-specific terminology enabling the sharing of biobank-related data for different purposes across a wide range of database implementations. After 4 years in use and with the first version of the individual-level MIABIS component Sample, Sample donor, and Event, it was necessary to revise the terminology, especially to include biobanks that work more in the data domain than with samples.Materials & Methods: Nine use-cases representing different types of biobanks, studies, and networks participated in the development work. They represent types of data, specific sample types, or levels of organization that were not included earlier in MIABIS. To support our revision of the Biobank entity, we conducted a survey of European biobanks to chart the services they provide. An important stakeholder group for biobanks include researchers as the main users of biobanks. To be able to render MIABIS more researcher-friendly, we collected different sample/data requests to analyze the terminology adjustment needs in detail. During the update process, the Core terminology was iteratively reviewed by a large group of experts until a consensus was reached.Results: With this update, MIABIS was adjusted to encompass data-driven biobanks and to include data collections, while also describing the services and capabilities biobanks offer to their users, besides the retrospective samples. The terminology was also extended to accommodate sample and data collections of nonhuman origin. Additionally, a set of organizational attributes was compiled to describe networks.Discussion: The usability of MIABIS Core v3 was increased by extending it to cover more topics of the biobanking domain. Additionally, the focus was on a more general terminology and harmonization of attributes with the individual-level entities Sample, Sample donor, and Event to keep the overall terminology minimal. With this work, the internal semantics of the MIABIS terminology was improved

An Internet-Based Real-Time Audiovisual Link for Dual MEG Recordings

Hyperscanning Most neuroimaging studies of human social cognition have focused on brain activity of single subjects. More recently, "two-person neuroimaging" has been introduced, with simultaneous recordings of brain signals from two subjects involved in social interaction. These simultaneous "hyperscanning" recordings have already been carried out with a spectrum of neuroimaging modalities, such as functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and functional near-infrared spectroscopy (fNIRS). Dual MEG Setup We have recently developed a setup for simultaneous magnetoencephalographic (MEG) recordings of two subjects that communicate in real time over an audio link between two geographically separated MEG laboratories. Here we present an extended version of the setup, where we have added a video connection and replaced the telephone-landline-based link with an Internet connection. Our setup enabled transmission of video and audio streams between the sites with a one-way communication latency of about 130 ms. Our software that allows reproducing the setup is publicly available. Validation We demonstrate that the audiovisual Internet-based link can mediate real-time interaction between two subjects who try to mirror each others' hand movements that they can see via the video link. All the nine pairs were able to synchronize their behavior. In addition to the video, we captured the subjects' movements with accelerometers attached to their index fingers; we determined from these signals that the average synchronization accuracy was 215 ms. In one subject pair we demonstrate inter-subject coherence patterns of the MEG signals that peak over the sensorimotor areas contralateral to the hand used in the task.Peer reviewe

Association Testing of Previously Reported Variants in a Large Case-Control Meta-analysis of Diabetic Nephropathy

We formed the GEnetics of Nephropathy–an International Effort (GENIE) consortium to examine previously reported genetic associations with diabetic nephropathy (DN) in type 1 diabetes. GENIE consists of 6,366 similarly ascertained participants of European ancestry with type 1 diabetes, with and without DN, from the All Ireland-Warren 3-Genetics of Kidneys in Diabetes U.K. and Republic of Ireland (U.K.-R.O.I.) collection and the Finnish Diabetic Nephropathy Study (FinnDiane), combined with reanalyzed data from the Genetics of Kidneys in Diabetes U.S. Study (U.S. GoKinD). We found little evidence for the association of the EPO promoter polymorphism, rs161740, with the combined phenotype of proliferative retinopathy and end-stage renal disease in U.K.-R.O.I. (odds ratio [OR] 1.14, P = 0.19) or FinnDiane (OR 1.06, P = 0.60). However, a fixed-effects meta-analysis that included the previously reported cohorts retained a genome-wide significant association with that phenotype (OR 1.31, P = 2 × 10−9). An expanded investigation of the ELMO1 locus and genetic regions reported to be associated with DN in the U.S. GoKinD yielded only nominal statistical significance for these loci. Finally, top candidates identified in a recent meta-analysis failed to reach genome-wide significance. In conclusion, we were unable to replicate most of the previously reported genetic associations for DN, and significance for the EPO promoter association was attenuated

Sensitivity of MEG and EEG to Source Orientation

An important difference between magnetoencephalography (MEG) and electroencephalography (EEG) is that MEG is insensitive to radially oriented sources. We quantified computationally the dependency of MEG and EEG on the source orientation using a forward model with realistic tissue boundaries. Similar to the simpler case of a spherical head model, in which MEG cannot see radial sources at all, for most cortical locations there was a source orientation to which MEG was insensitive. The median value for the ratio of the signal magnitude for the source orientation of the lowest and the highest sensitivity was 0.06 for MEG and 0.63 for EEG. The difference in the sensitivity to the source orientation is expected to contribute to systematic differences in the signal-to-noise ratio between MEG and EEG.National Institutes of Health (U.S.) (Grant NS057500)National Institutes of Health (U.S.) (Grant NS037462)National Institutes of Health (U.S.) (Grant HD040712)National Center for Research Resources (U.S.) (P41RR14075)Mind Research Networ