Longitudinal evaluation of cognition after stroke - A systematic scoping review

BACKGROUND: Cognitive impairment affects up to 80 percent of the stroke population, however, both the available evidence about post-stroke cognition and the measures used to evaluate it longitudinally have not been well described. The aims of this systematic scoping review were: to identify and characterize studies evaluating cognition longitudinally after stroke; to summarize the cognitive instruments used and the domains they target; and to organize cognitive domains assessed using the International Classification of Functioning, Disability and Health (ICF). METHODS: We used a systematic scoping approach to search for peer-reviewed articles involving adults with stroke that evaluated cognition longitudinally. Screening of titles, abstracts, and full reports was completed independently by two reviewers, across six electronic databases (PubMed, PsycInfo, Medline, Cinahl Plus, Embase, and Web of Science). Cognitive domains were mapped to an ICF function independently by the same two reviewers, using a previously tested, standardized approach. RESULTS: A total of 5,540 records were found; 257 were included, representing a total pooled sample of 120,860 stroke survivors. Of these studies, 200 (78%) provided specific cognitive outcomes from the longitudinal evaluations, 57 (22%) reported model predictions, and 77 (30%) included interventions. Cognition was evaluated with 356 unique instruments, targeting 95 distinct cognitive domains, and 17 mental functions from the ICF. The Mini-Mental State Examination was the most frequently used instrument (117 reports, 46%). Other tools used longitudinally were the Trail Making Test (17% of reports), tests of verbal fluency (14%), the Functional Independence Measure (14%), the Montreal Cognitive Assessment (13%), the Digit Span (11%), and the Stroop test (10%). Global cognition was evaluated in 170 reports (66%), followed by higher-level cognitive functioning (29%), memory (28%), language (21%), attention (21%), and perceptual skills (14%). Studies using functional (or performance-based) cognitive assessments over time were scarce (\u3c 1%). CONCLUSION: Our findings indicate that whilst there is a substantial number of studies available that report longitudinal evaluations of cognition after stroke, there is large variability in the measures used and the cognitive domains they target. Nonetheless, the available data for evaluation of cognition over time after stroke can be organized and described systematically

Conditioned Medium from Human Uterine Cervical Stem Cells Regulates Oxidative Stress and Angiogenesis of Retinal Pigment Epithelial Cells

[Abstract] Introduction: Retinal homeostasis is essential to avoid retinal pigment epithelium (RPE) damage resulting in photoreceptor death and blindness. Mesenchymal stem cells-based cell therapy could contribute to the maintenance of the retinal homeostasis. We have explored the effect of human uterine cervical stem cells (hUCESCs)-conditioned medium (hUCESC-CM) on RPE cells under oxidative stress condition. Methods: ARPE-19 cells were treated with hydrogen peroxide (H2O2) in the presence or absence of hUCESC-CM. qRT-PCR and Western blot were used to evaluate the expression of oxidative stress-related (HO-1, GCLC, and HSPB1) and vasculogenesis-related (VEGFA, PDGFA, and PDGFB) factors. Also, we assessed in vitro effects of hUCESC-CM on endothelial-cell (HUVEC) tube formation. Results: mRNA expression of HO-1, GCLC, HSPB1, VEGFA, PDGFA, and PDGFB were significantly increased in ARPE-19 cells treated with H2O2 + hUCESC-CM compared to cells treated with H2O2 only. Regarding the tube formation assay, HUVEC treated with supernatant from ARPE-19 cells treated with H2O2 + hUCESC-CM showed a significant increase in average vessel length, number of capillary-like junctions, and average of vessels area compared with HUVEC treated with supernatant from ARPE-19 cells treated with H2O2 only. Conclusion: Our results show potential therapeutic effects of hUCESC-CM on RPE, such as protection from damage by oxidative stress, stimulation of detoxifying genes, and a better vascularization.This research was supported by grants to R.P.-F. from Ministerio de Economia y Competividad (SAF2015-69221-R), to N.E. and F.J.V from Instituto de Salud Carlos III (PI20/01122) and cofunded by European Union (ERDF/ESF, “Investing in your future”), by Fundación para la Investigación con Células Madre Uterinas (FICEMU) to R.P.F. and F.J.V., and by ONCE (Organización Nacional de Ciegos Españoles) to F.J.V. S.C. was recipient of a fellowship financed by the Gobierno del Principado de Asturias “Severo Ochoa” PhD Program under Grant BP14-128. The APC was funded by Instituto de Salud Carlos III (PI20/01122)

Characterization and individual-level prediction of cognitive state in the first year after \u27mild\u27 stroke

BACKGROUND: Mild stroke affects more than half the stroke population, yet there is limited evidence characterizing cognition over time in this population, especially with predictive approaches applicable at the individual-level. We aimed to identify patterns of recovery and the best combination of demographic, clinical, and lifestyle factors predicting individual-level cognitive state at 3- and 12-months after mild stroke. METHODS: In this prospective cohort study, the Montreal Cognitive Assessment (MoCA) was administered at 3-7 days, 3- and 12-months post-stroke. Raw changes in MoCA and impairment rates (defined as MoCA\u3c24 points) were compared between assessment time-points. Trajectory clusters were identified using variations of ≥1 point in MoCA scores. To further compare clusters, additional assessments administered at 3- and 12-months were included. Gamma and Quantile mixed-effects regression were used to predict individual MoCA scores over time, using baseline clinical and demographic variables. Model predictions were fitted for each stroke survivor and evaluated using model cross-validation to identify the overall best predictors of cognitive recovery. RESULTS: Participants\u27 (n = 119) MoCA scores improved from baseline to 3-months (p\u3c0.001); and decreased from 3- to 12-months post-stroke (p = 0.010). Cognitive impairment rates decreased significantly from baseline to 3-months (p\u3c0.001), but not between 3- and 12-months (p = 0.168). Nine distinct trajectory clusters were identified. Clinical characteristics between clusters at each time-point varied in cognitive outcomes but not in clinical and/or activity participation outcomes. Cognitive performance at 3- and 12-months was best predicted by younger age, higher physical activity levels, and left-hemisphere lesion side. CONCLUSION: More than half of mild-stroke survivors are at risk of cognitive decline one year after stroke, even when preceded by a significantly improving pattern in the first 3-months of recovery. Physical activity was the only modifiable factor independently associated with cognitive recovery. Individual-level prediction methods may inform the timing and personalized application of future interventions to maximize cognitive recovery post-stroke

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Search for supersymmetry in events with one lepton and multiple jets in proton-proton collisions at root s=13 TeV

Peer reviewe

Measurement of the top quark mass using charged particles in pp collisions at root s=8 TeV

Peer reviewe

Search for heavy resonances decaying to two Higgs bosons in final states containing four b quarks

A search is presented for narrow heavy resonances X decaying into pairs of Higgs bosons (H) in proton-proton collisions collected by the CMS experiment at the LHC at root s = 8 TeV. The data correspond to an integrated luminosity of 19.7 fb(-1). The search considers HH resonances with masses between 1 and 3 TeV, having final states of two b quark pairs. Each Higgs boson is produced with large momentum, and the hadronization products of the pair of b quarks can usually be reconstructed as single large jets. The background from multijet and t (t) over bar events is significantly reduced by applying requirements related to the flavor of the jet, its mass, and its substructure. The signal would be identified as a peak on top of the dijet invariant mass spectrum of the remaining background events. No evidence is observed for such a signal. Upper limits obtained at 95 confidence level for the product of the production cross section and branching fraction sigma(gg -> X) B(X -> HH -> b (b) over barb (b) over bar) range from 10 to 1.5 fb for the mass of X from 1.15 to 2.0 TeV, significantly extending previous searches. For a warped extra dimension theory with amass scale Lambda(R) = 1 TeV, the data exclude radion scalar masses between 1.15 and 1.55 TeV

Diseño de propuesta para separación y disposición adecuada de residuos sólidos orgánicos de origen vegetal de la plaza de mercado Santa Elena en la ciudad de Santiago de Cali

La generación de residuos sólidos orgánicos es un proceso que no puede desaparecer ya que se encuentra directamente relacionada con el consumo de alimentos de los individuos. En el mundo anualmente se generan 1300 millones de toneladas de residuos sólidos al año, de los cuales el 46% corresponde a residuos sólidos orgánicos colapsando así los rellenos sanitarios o botaderos. En Colombia se producen alrededor de 10 millones de toneladas al año, de los cuales el 63% corresponde a RSOOV. Esta misma situación se evidencia en Cali generando 1513 toneladas diarias de residuos sólidos, en donde los mayores generadores son los restaurantes, hoteles, viviendas y plazas de mercado, en específico la plaza de mercado Santa Elena (SE) la cual genera un 16.9% de las 1631 toneladas generadas por todas las plazas de mercado de la ciudad al año. En general las plazas de mercado de la ciudad tienen un ambiente carente de orden y aseo, el cual hace que se evidencie la falta de cultura y conocimientos en cuanto a la separación, disposición y reciclaje de residuos por parte de la población, teniendo en cuenta lo anterior, se hizo necesario para las plazas de mercado el diseño de una forma sencilla de separación en la fuente, un sistema de recolección que mantenga dicha separación y finalmente una programación de ahorro de distancias para organizar rutas con menor distancian y se realice la recolección de los residuos alrededor de estas. El proceso comenzó con la recolección de información en la plaza de mercado que permitió identificar las falencias que se presentan allí día a día. Teniendo esto, se procedió a la búsqueda de información sobre las posibilidades de disminuir los errores que existían. La solución de la situación integro dos propuestas de diseño: un puesto de trabajo para los comerciantes de la plaza de mercado y el mejoramiento de las condiciones de trabajo del recolector de basura y su herramienta de trabajo. Avalado por un análisis financiero que sustenta la viabilidad de la implementación de este proyecto. Finalmente, se recomendó a la administración de la plaza la implementación de este proyecto dado que puede generarles en un plazo de cinco años aproximadamente $77´000,000 de pesos colombianos y además estarían realizando un aporte significativo a la disminución de residuos sólidos que no serán aprovechados adecuadamente.The generation of organic solid waste is a process that can not disappear as it is directly related to the consumption of food by individuals. In the world, 1300 million tons of solid waste are generated annually, of which 46In Colombia around 10 million tons are produced per year, of which 63In general, the market places of the city have an environmental lack in order and cleanliness, which makes evident the lack of culture and knowledge of the separation, disposal and recycling of waste by the population, taking into account this, it became necessary for the market places the design of a simple form of separation at the source, a collection system that maintains this separation and finally a distance saving model to organize routes with less distance and to perform the collection of waste around them. The process began with the collection of information in the market place that allowed us to identify the shortcomings that are presented there day by day. Having this, we proceeded to the search for information about the possibilities of eliminating the errors that existed. The solution of the whole situation is a two proposals design: A workstation for the merchants of the 2 market place and the improvement of the working conditions of the garbage collector and his work tool. Endorsed by a financial analysis that supports the viability of the implementation of this project. Finally, the implementation of this project was recommended to the administration of the market place since it could generate approximately$ 77,000,000 Colombian pesos over a period of five years and would also be making a significant contribution to the reduction of solid waste that will not be used properly

Subjetividade em grupos de pessoas em situação de deficiência: explorar a dualidade sujecion-agencia e vista da deficiência da própria experiência

The concept of disability, defined as a social construct, comprises corporality, stereotypes, and behaviors of self-acceptance or rejection. Subsequent implications of disability at the personal and collective level demand an improvement in its professional comprehension and action. This study’s purposes are to explore the subjective constructions of people with disabilities who are members of groups of people with disabilities; and to describe how these constructions influence both occupations and the way people organize as members of groups of people with disabilities. Contact with participants, data collection, and data analysis were completed through key informants, semi-structured interviews, and the Categorical Content Analysis method, respectively. Results revealed two tendencies of group function that may coexist; the first relates to a demanding standpoint - that is, claiming what is believed to be a right; and the second to a problem-causing standpoint - or arguing what seems to be irrefutable -. Finally, subjective construction of individuals was understood as the fine line existing between the subjection-agency practices related to their disability, as well as the submission to normative models and/or the criticism towards infantilization and assistencialism.La discapacidad como constructo social está compuesta por corporalidad, estereotipos y conductas de auto aceptación o negación. La discapacidad tiene implicancias a nivel personal y colectivo, demandando un perfeccionamiento en las perspectivas actuales de acción y comprensión por parte de los profesionales vinculados con esta realidad. Esta investigación se realizó con dos propósitos: explorar las construcciones subjetivas de personas en situación de discapacidad que forman parte de agrupaciones de personas con discapacidad; y describir cómo éstas influyen en su forma de organizarse y en sus ocupaciones. El contacto con los y las participantes se realizó mediante la estrategia de informantes clave, la recolección de datos a través de una entrevista semiestructurada y el método de análisis mediante la técnica de análisis de contenido (categorial). Los resultados muestran dos tendencias de funcionamiento en las agrupaciones que pueden llegar a coexistir en un mismo período. La primera de corte reivindicativo (demandar lo que se considera derecho propio) y la segunda tendencia problematizadora (poner en discusión lo que parece una idea irrefutable). Finalmente, la construcción de las personas se comprende desde la tensión existente entre las prácticas de sujeción y agencia relacionadas a la discapacidad, como la sumisión frente a modelos normativos y/o la crítica a la infantilización y asistencialismo.Deficiência como uma construção social consiste de corporeidade, estereótipos e comportamentos de auto aceitação ou negação. Deficiência tem implicações para individualmente e coletivamente, exigindo uma melhoria na perspectiva atual da ação e compreensão por profissionais ligados com esta realidade. Esta pesquisa foi realizada com dois objetivos: explorar construções subjetivas das pessoas em situação de incapacidade que fazem parte de grupos de pessoas com deficiência; e descrever como estes influenciam a sua forma de organização e de suas ocupações. Contato com os participantes foi realizado usando a estratégia dos informadores-chave, coleta de dados através de uma entrevista semi-estruturada e o método de análise usando a técnica do conteúdo (categórica) de análise. Os resultados mostram duas tendências trabalhando em grupos que podem coexistir no mesmo período. O primeiro corte de protesto (alegando que é considerado direito próprio) e a segunda tendência problematizing (colocar em discussão o que parece uma ideia irrefutável). Finalmente, entende-se a construção do povo da tensão entre sujeito e agência práticas relacionadas à deficiência, em comparação com a apresentação de modelos normativos e/ou crítica da infantilização e assistência

A Systematic Review of Research Gaps in the Built Environment of Inpatient Healthcare Settings

Objective: This study utilized the evidence-gap map method and critically examined the scope, methodologies, and focus of the studies that investigated the influence of the built environment on inpatient healthcare settings over a decade (2010–2021). Methods: We conducted a systematic review per the preferred reporting items for systematic reviews and meta-analyses guidelines and surveyed 406 articles, primarily from North America and Europe. Results: Our findings revealed a dominant focus on architectural features (73%), such as room design and ward layout. Comparatively, there was less emphasis on interior-, ambient-, social-, and nature-related features. Most previous studies explored multiple environmental features, which indicated the intricacy of this field. Research outcomes were diverse, with person-centered care (PCC) being the most frequently investigated, followed by safe care, emotional well-being, activity, and behavior. Furthermore, research methods varied considerably based on the study’s outcomes and features. Clinical outcomes and safe care favored quantitative methods, activity and behavior favored mixed methods, and PCC favored qualitative research. Conclusion: This review provides an in-depth overview of the existing studies on healthcare design research and sheds light on the current trends and methodological choices. The insights garnered can guide future research, policy-making, and the development of healthcare facilities.</p