-
PLOS Digital Health Jun 2024Analysing complex diseases such as chronic inflammatory joint diseases (CIJDs), where many factors influence the disease evolution over time, is a challenging task....
Analysing complex diseases such as chronic inflammatory joint diseases (CIJDs), where many factors influence the disease evolution over time, is a challenging task. CIJDs are rheumatic diseases that cause the immune system to attack healthy organs, mainly the joints. Different environmental, genetic and demographic factors affect disease development and progression. The Swiss Clinical Quality Management in Rheumatic Diseases (SCQM) Foundation maintains a national database of CIJDs documenting the disease management over time for 19'267 patients. We propose the Disease Activity Score Network (DAS-Net), an explainable multi-task learning model trained on patients' data with different arthritis subtypes, transforming longitudinal patient journeys into comparable representations and predicting multiple disease activity scores. First, we built a modular model composed of feed-forward neural networks, long short-term memory networks and attention layers to process the heterogeneous patient histories and predict future disease activity. Second, we investigated the utility of the model's computed patient representations (latent embeddings) to identify patients with similar disease progression. Third, we enhanced the explainability of our model by analysing the impact of different patient characteristics on disease progression and contrasted our model outcomes with medical expert knowledge. To this end, we explored multiple feature attribution methods including SHAP, attention attribution and feature weighting using case-based similarity. Our model outperforms temporal and non-temporal neural network, tree-based, and naive static baselines in predicting future disease activity scores. To identify similar patients, a k-nearest neighbours regression algorithm applied to the model's computed latent representations outperforms baseline strategies that use raw input features representation.
PubMed: 38935600
DOI: 10.1371/journal.pdig.0000422 -
PLOS Digital Health Jun 2024Study-specific data quality testing is an essential part of minimizing analytic errors, particularly for studies making secondary use of clinical data. We applied a...
Study-specific data quality testing is an essential part of minimizing analytic errors, particularly for studies making secondary use of clinical data. We applied a systematic and reproducible approach for study-specific data quality testing to the analysis plan for PRESERVE, a 15-site, EHR-based observational study of chronic kidney disease in children. This approach integrated widely adopted data quality concepts with healthcare-specific evaluation methods. We implemented two rounds of data quality assessment. The first produced high-level evaluation using aggregate results from a distributed query, focused on cohort identification and main analytic requirements. The second focused on extended testing of row-level data centralized for analysis. We systematized reporting and cataloguing of data quality issues, providing institutional teams with prioritized issues for resolution. We tracked improvements and documented anomalous data for consideration during analyses. The checks we developed identified 115 and 157 data quality issues in the two rounds, involving completeness, data model conformance, cross-variable concordance, consistency, and plausibility, extending traditional data quality approaches to address more complex stratification and temporal patterns. Resolution efforts focused on higher priority issues, given finite study resources. In many cases, institutional teams were able to correct data extraction errors or obtain additional data, avoiding exclusion of 2 institutions entirely and resolving 123 other gaps. Other results identified complexities in measures of kidney function, bearing on the study's outcome definition. Where limitations such as these are intrinsic to clinical data, the study team must account for them in conducting analyses. This study rigorously evaluated fitness of data for intended use. The framework is reusable and built on a strong theoretical underpinning. Significant data quality issues that would have otherwise delayed analyses or made data unusable were addressed. This study highlights the need for teams combining subject-matter and informatics expertise to address data quality when working with real world data.
PubMed: 38935590
DOI: 10.1371/journal.pdig.0000527 -
Probiotics and Antimicrobial Proteins Jun 2024As the population ages, cognitive decline becomes more common. Strategies targeting the gut-brain axis using probiotics are emerging to achieve improvements in...
Cognitive and Emotional Effect of a Multi-species Probiotic Containing Lactobacillus rhamnosus and Bifidobacterium lactis in Healthy Older Adults: A Double-Blind Randomized Placebo-Controlled Crossover Trial.
As the population ages, cognitive decline becomes more common. Strategies targeting the gut-brain axis using probiotics are emerging to achieve improvements in neuropsychiatric and neurological disorders. However, the beneficial role of probiotics on brain function in healthy older adults remains unclear. Our aim was to evaluate a multi-species probiotic formulation as a therapeutic approach to reduce emotional and cognitive decline associated with aging in healthy adults. A randomized double-blind placebo-controlled crossover trial was conducted. The study involved a 10-week intervention where participants consumed the assigned probiotic product daily, followed by a 4-week washout period before the second condition started. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Psychological Experiments Construction Language Test Battery. At the emotional level, the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) were used. Thirty-three participants, recruited between July 2020 and April 2022, ingested a multispecies probiotic (Lactobacillus rhamnosus and Bifidobacterium lactis). After the intervention, noticeable enhancements were observed in cognitive function (mean difference 1.90, 95% CI 1.09 to 2.70, p < 0.005), memory (mean difference 4.60, 95% CI 2.91 to 6.29, p < 0.005) by MMSE and digit task, and depressive symptoms (mean difference 4.09, 95% CI 1.70 to 6.48, p < 0.005) by BDI. Furthermore, there were significant improvements observed in planning and problem-solving skills, selective attention, cognitive flexibility, impulsivity, and inhibitory ability. Probiotics administration improved cognitive and emotional function in older adults. Limited research supports this, requiring more scientific evidence for probiotics as an effective therapy for cognitive decline. This study has been prospectively registered at ClinicalTrials.gov (NCT04828421; 2020/July/17).
PubMed: 38935259
DOI: 10.1007/s12602-024-10315-2 -
Techniques in Hand & Upper Extremity... Jun 2024The KliniTray "breast board" used by many oncological breast surgeons is an innovative idea to succor microsurgical digital replantation. This piece of sterile equipment...
The KliniTray "breast board" used by many oncological breast surgeons is an innovative idea to succor microsurgical digital replantation. This piece of sterile equipment is readily available and provides excellent immobilization and retraction of the skin of digital amputates with minimal trauma. The fine metal pins are the key to its efficacy. They provide the flexibility to alter the position of the amputated part and alter the retraction of skin edges as many times as necessary. The construct acts as a tremor-free assistant for a single surgeon to efficiently prepare the amputated part of a digit, saving time including expensive theatre time.
PubMed: 38934540
DOI: 10.1097/BTH.0000000000000487 -
Neuropsychopharmacology Reports Jun 2024Persistent cognitive impairment is a serious consequence of the post-COVID condition. However, there have been no established effective treatments for this...
BACKGROUND
Persistent cognitive impairment is a serious consequence of the post-COVID condition. However, there have been no established effective treatments for this pathophysiology supported by sufficient evidence.
CASE PRESENTATION
A 32-year-old woman became aware of difficulty in word recalling, reading, and writing as well as difficulty in completing various household multitasks 3 weeks after the COVID-19 infection. Although blood tests, magnetic resonance imaging, electroencephalography, and Kohs block design test were all within normal limits, completion time by trail making test (TMT) A or B was markedly delayed. Finally, she was referred to our hospital 3 months after the infection. At baseline, the THINC integrated tool (THINC-it), a digital battery consisting of the five-item version of the perceived deficit questionnaire (PDQ-5), choice reaction time (CRT), 1-back test, digit symbol substitution test (DSST), and TMT-B, revealed poor capability in attention, working memory, and executive function. Also, near-infrared spectroscopy (NIRS) demonstrated no activation in frontal or temporal regions during verbal fluency task. Extended-release guanfacine (GXR) 2 mg/day was initiated and a month later was elevated up to 4 mg/day as a maintenance dose. The PDQ-5, CRT, 1-back test, DSST, and TMT-B were dramatically improved 1 month after GXR treatment. NIRS finding was also normalized after 2 months of treatment. These effects were successfully maintained throughout the 6-month follow-up period.
CONCLUSION
GXR may be helpful in improving subjective/objective cognitive functioning and frontotemporal brain activity in long-COVID patients manifesting apparent cognitive impairment.
PubMed: 38934345
DOI: 10.1002/npr2.12466 -
Frontiers in Digital Health 2024Prompt engineering, the process of arranging input or prompts given to a large language model to guide it in producing desired outputs, is an emerging field of research... (Review)
Review
Prompt engineering, the process of arranging input or prompts given to a large language model to guide it in producing desired outputs, is an emerging field of research that shapes how these models understand tasks, process information, and generate responses in a wide range of natural language processing (NLP) applications. Digital mental health, on the other hand, is becoming increasingly important for several reasons including early detection and intervention, and to mitigate limited availability of highly skilled medical staff for clinical diagnosis. This short review outlines the latest advances in prompt engineering in the field of NLP for digital mental health. To our knowledge, this review is the first attempt to discuss the latest prompt engineering types, methods, and tasks that are used in digital mental health applications. We discuss three types of digital mental health tasks: classification, generation, and question answering. To conclude, we discuss the challenges, limitations, ethical considerations, and future directions in prompt engineering for digital mental health. We believe that this short review contributes a useful point of departure for future research in prompt engineering for digital mental health.
PubMed: 38933900
DOI: 10.3389/fdgth.2024.1410947 -
Nutrients Jun 2024Ashwagandha has been reported to reduce stress and attenuate cognitive decline associated with inflammation and neurodegeneration in clinical populations. However, the... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Ashwagandha has been reported to reduce stress and attenuate cognitive decline associated with inflammation and neurodegeneration in clinical populations. However, the effects as a potential nootropic nutrient in younger populations are unclear. This study examined the effects of liposomal ashwagandha supplementation on cognitive function, mood, and markers of health and safety in healthy young men and women.
METHODS
59 men and women (22.7 ± 7 yrs., 74.9 ± 16 kg, 26.2 ± 5 BMI) fasted for 12 h, donated a fasting blood sample, and were administered the COMPASS cognitive function test battery (Word Recall, Word recognition, Choice Reaction Time Task, Picture Recognition, Digit Vigilance Task, Corsi Block test, Stroop test) and profile of mood states (POMS). In a randomized and double-blind manner, participants were administered 225 mg of a placebo (Gum Arabic) or ashwagandha () root and leaf extract coated with a liposomal covering. After 60-min, participants repeated cognitive assessments. Participants continued supplementation (225 mg/d) for 30 days and then returned to the lab to repeat the experiment. Data were analyzed using a general linear model (GLM) univariate analysis with repeated measures and pairwise comparisons of mean changes from baseline with 95% confidence intervals (CI).
RESULTS
Ashwagandha supplementation improved acute and/or 30-day measures of Word Recall (correct and recalled attempts), Choice Reaction Time (targets identified), Picture Recognition ("yes" correct responses, correct and overall reaction time), Digit Vigilance (correct reaction time), Stroop Color-Word (congruent words identified, reaction time), and POMS (tension and fatigue) from baseline more consistently with several differences observed between groups.
CONCLUSION
Results support contentions that ashwagandha supplementation (225 mg) may improve some measures of memory, attention, vigilance, attention, and executive function while decreasing perceptions of tension and fatigue in younger healthy individuals. Retrospectively registered clinical trial ISRCTN58680760.
Topics: Humans; Male; Female; Cognition; Double-Blind Method; Dietary Supplements; Young Adult; Adult; Affect; Plant Extracts; Adolescent; Reaction Time; Biomarkers; Liposomes; Plant Leaves; Plant Roots
PubMed: 38931168
DOI: 10.3390/nu16121813 -
Brain Sciences Jun 2024The present study explores comparatively the effectiveness of a cognitive (verbal short-term memory (vSTM), verbal working memory (vWM)) and of a linguistic training...
The present study explores comparatively the effectiveness of a cognitive (verbal short-term memory (vSTM), verbal working memory (vWM)) and of a linguistic training (10-week duration each) in the diffusion of gains in cognitive abilities (vSTM and vWM) of in school-aged Greek-speaking children with developmental language disorder (DLD). To this purpose, two computerized training programs i.e., a linguistic and a cognitive one, were developed and applied to three groups (A, B, and C) of children with DLD (N = 49, in total). There were three assessments with two vSTM tasks (non-word repetition and forward digit span) and a vWM task (backward digit span): pre-therapeutically (time 1), where no significant between-group differences were found, post-therapeutically I (time 2), and post-therapeutically II (time 3) and two training phases. In phase Ι, group A received meta-syntactic training, whereas group B vSTM/vWM training and group C received no training. In phase ΙΙ, a reversal of treatment was performed for groups A and B: group A received vSTM/vWM while group B meta-syntactic training. Again, group C received no training. Overall, the results indicated a significant performance improvement for the treatment groups and revealed beneficial far-transfer effects as language therapy can affect vSTM and vWM in addition to direct and near transfer effects. In addition, the intervention type order affected performance as follows: first, better performance on the vSTM task (non-word repetition) was shown when the linguistic treatment was delivered first; second, better performance on the vWM in Time 2 and Time 3 was shown by group B, for which the cognitive treatment was delivered first. Concluding, not only intervention type but also intervention type order can affect performance in DLD.
PubMed: 38928580
DOI: 10.3390/brainsci14060580 -
Brain Sciences May 2024Decreased attentional function causes problems in daily life. However, a quick and easy evaluation method of attentional function has not yet been developed. Therefore,...
Decreased attentional function causes problems in daily life. However, a quick and easy evaluation method of attentional function has not yet been developed. Therefore, we are searching for a method to evaluate attentional function easily and quickly. This study aimed to collect basic data on the features of electroencephalography (EEG) during attention tasks to develop a new method for evaluating attentional function using EEG. Twenty healthy young adults participated; we examined cerebral activity during a Clinical Assessment for Attention using portable EEG devices. The Mann-Whitney U test was performed to assess differences in power levels of EEG during tasks between the low- and high-attention groups. The findings revealed that the high-attention group showed significantly higher EEG power levels in the δ wave of L-temporal and bilateral parietal lobes, as well as in the β and γ waves of the R-occipital lobe, than did the low-attention group during digit-forward, whereas the high-attention group showed significantly higher EEG power levels in the θ wave of R-frontal and the α wave of bilateral frontal lobes during digit-backward. Notably, lower θ, α, and β bands of the right hemisphere found in the low-attention group may be key elements to detect attentional deficit.
PubMed: 38928528
DOI: 10.3390/brainsci14060527 -
Genes May 2024Mutations in the gene are associated with a diverse spectrum of retinopathies with phenotypic variability causing severe visual impairment. The gene has a role in...
UNLABELLED
Mutations in the gene are associated with a diverse spectrum of retinopathies with phenotypic variability causing severe visual impairment. The gene has a role in retinal development and is expressed in the cerebral cortex and hippocampus, but its role in cognition has not been described before. This study compares cognitive function in retinopathy individuals with subjects with other retinopathies and the normal population.
METHODS
Neuropsychological tests of cognitive function were used to test individuals with and non- retinopathies and compare results with a standardised normative dataset.
RESULTS
retinopathy subjects significantly outperformed those with non- retinopathy in list learning tasks of immediate ( = 0.001) and delayed memory ( = 0.007), tests of verbal fluency ( = 0.017), verbal IQ digit span subtest ( = 0.037), and estimation test of higher execution function ( = 0.020) but not in the remaining tests of cognitive function ( > 0.05). retinopathy subjects scored significantly higher than the normal population in all areas of memory testing ( < 0.05) and overall verbal IQ tests ( = 0.0012). Non- retinopathy subjects scored significantly higher than the normal population in story recall, verbal fluency, and overall verbal IQ tests ( = 0.0016).
CONCLUSIONS
Subjects with retinopathy may have enhanced cognitive function in areas of memory and learning. Further work is required to understand the role of in cognition.
Topics: Humans; Nerve Tissue Proteins; Male; Female; Membrane Proteins; Adult; Middle Aged; Eye Proteins; Memory; Retinal Diseases; Neuropsychological Tests; Cognition; Learning; Young Adult; Adolescent; Aged
PubMed: 38927596
DOI: 10.3390/genes15060660