Activities of Daily Living Inventory (ADLI): Proposal of a new instrument and preliminary data.

The evaluation of Activities of Daily Living (ADL) has become a critical issue in neuropsychology, but existing instruments for evaluating ADL have some limitations. This work aims to propose a new instrument to evaluate ADL, the ADL Inventory (ADLI), for which we present preliminary data.The ADLI was developed based on a comprehensive model of the stages of test development and following a combined framework of the World Health Organization's International Classification of Functioning, Disability, and Health and the American Occupational Therapy Association models.Besides sociodemographic information, ADLI includes 144 items, organized into four sections: (a) basic ADL; (b) IADL; (c) advanced ADL; and (d) factors influencing functionality. The main characteristics of ADLI are: having self- and informant-report forms; including items focused on different sensory and neurocognitive functions; individualizing the progression along items considering the person's functionality; considering the impact of several factors on functionality; and using a large response scale. Preliminary data of predictive and convergent validity for ADLI are presented. The preliminary study comprised 15 older adults. The Addenbrooke's Cognitive Examination - III, the Barthel Index, and the Instrumental Activities of Daily Living (IADL) Scale were applied to determine the predictive and convergent validity of ADLI.

Ecological validity of neuropsychological interventions: A systematic review.

BACKGROUND: The concept of ecological validity (EV) in neuropsychological interventions (NI) has been consistently advocated, but there is a lack of reviews focused on how EV is operationalized in NI programmes. This review aims to address this gap by exploring the outcome measures more commonly used for assessing EV and to understand the main characteristics of programmes with good EV. METHOD: A literature search was conducted to identify studies that examined the EV of NI programmes, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Collaboration Guidelines. RESULTS: A total of twenty-seven studies were included in this review. Among these, only three studies explicitly described the procedures used to assess EV. Additionally, almost half of the studies assumed that interventions had good EV based on the characteristics of the programmes. The inconsistent assessment of EV of NI programmes prevented the identification of specific characteristics of programmes demonstrating good EV. CONCLUSION: This systematic review reveals a significant gap in the literature concerning the operationalization of EV within the field of NI. Further research is required to establish a consistent definition of EV in the context of NI and to develop criteria for its effective operationalization.

Measures of cognitive reserve: An umbrella review.

Objective: Recently, there has been a growing interest in operationalizing and measuring cognitive reserve (CR) for clinical and research purposes. This umbrella review aims to summarize the existing systematic and meta-analytic reviews about measures of CR. Method: A literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the guidelines of Aromataris et al. (2015) to identify the systematic reviews and meta-analysis involving the assessment of CR. The methodological quality of the papers included in this umbrella review was assessed with A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) and Specialist Unit for Review Evidence (SURE). Results: Thirty-one reviews were identified, sixteen of which were systematic reviews, and fifteen were meta-analyses. Most of the reviews had a critically low quality, according to AMSTAR-2. The reviews included between two and 135 studies. Most of the papers focused on older adults, mainly those with dementia. CR was measured using one to six proxies, but most considered each proxy separately. The most assessed proxies of CR were education on its own, combined with occupation and/or engagement in activities or combined with parental education, bilingualism, and engagement in activities when four CR proxies were studied. Most of the studies included in higher quality reviews focused on three proxies, with education and engagement in activities being the most evaluated using CR questionnaires. Conclusion: Despite the growing interest in measuring CR, its operationalization did not improve since the last umbrella review in this field.

HOS1 promotes plant tolerance to low-energy stress via the SnRK1 protein kinase.

Plants need to integrate internal and environmental signals to mount adequate stress responses. The NUCLEAR PORE COMPLEX (NPC) component HIGH EXPRESSION OF OSMOTICALLY RESPONSIVE GENES 1 (HOS1) is emerging as such an integrator, affecting responses to cold, heat, light, and salinity. Stress conditions often converge in a low-energy signal that activates SUCROSE NON-FERMENTING 1-RELATED KINASE 1 (SnRK1) to promote stress tolerance and survival. Here, we explored the role of HOS1 in the SnRK1-dependent response to low-energy stress in Arabidopsis thaliana, using darkness as a treatment and a combination of genetic, biochemical, and phenotypic assays. We show that the induction of starvation genes and plant tolerance to prolonged darkness are defective in the hos1 mutant. HOS1 interacts physically with the SnRK1α1 catalytic subunit in yeast two-hybrid assays and in planta, and the nuclear accumulation of SnRK1α1 is reduced in the hos1 mutant. Likewise, another NPC mutant, nup160, exhibits lower activation of starvation genes and decreased tolerance to prolonged darkness. Importantly, defects in low-energy responses in the hos1 background are rescued by fusing SnRK1α1 to a potent nuclear localization signal or by sugar supplementation during the dark treatment. Altogether, this work demonstrates the importance of HOS1 for the nuclear accumulation of SnRK1α1, which is key for plant tolerance to low-energy conditions.

Proposal of a common terminology for the neuropsychological rehabilitation.

The literature on neuropsychological intervention (NI) uses a variety of terms to refer to equivalent constructs, making it difficult to compare intervention programmes and their outcomes. The purpose of this work is to propose a unified terminological framework for describing NI programmes. The terminological framework was developed based on a previous proposal for common terminology by Johnstone and Stonnington (Rehabilitation of neuropsychological disorders: A practical guide for rehabilitation professionals. Psychology Press, 2011) and driven by Cognitive Psychology concepts. The terminological framework was organized into two sections: (a) NI, which includes types of NI, methods and approaches, instructional methods, and strategies; and (b) neurocognitive functions, which include temporal and spatial orientation, sensation, perception, visuo-constructional abilities, attention, memory, language, reasoning of several sorts (e.g., abstract reasoning, and numerical reasoning), and executive functions. Most NI tasks target a main neurocognitive function, but there are underlying neurocognitive functions that may impair performance in the former. Since it is difficult to create a task that is solely focused on one neurocognitive function, the proposed terminology should not be viewed as a taxonomy, but rather as dimensional, with the same task allowing to work different functions, in varying grades. Adopting this terminological framework will allow to define the targeted neurocognitive functions more accurately and simplify the comparison between NI programmes and their outcomes. Future research should focus on describing the main techniques/strategies for each neurocognitive function and non-cognitive interventions.

Ecological validity in neurocognitive assessment: Systematized review, content analysis, and proposal of an instrument.

OBJECTIVES: The main objectives of this study are to identify the dimensions of Ecological Validity (EV) within the definitions of this concept, understand how they are operationalized in neurocognitive tests, and propose a checklist for EV attributes in neurocognitive tests. METHOD: A systematized review was combined with content analysis of the selected papers, using the inductive method. We analyzed 82 studies on the EV of neurocognitive tests, 19 literature reviews and 63 empirical studies. Based on this review, we identified the relevant criteria for evaluating EV. RESULTS: EV is a multidimensional concept with two main dimensions: representativeness and generalization. Representativeness involves the subdimensions simplicity-complexity and artificial-natural and several criteria organized on a continuum from low EV to high EV. Generalization is dependent on representativeness and is influenced by different cognitive and non-cognitive factors. We propose six stages for operationalizing EV, from defining the objectives of the neurocognitive assessment to the methodology for scoring and interpreting the results. CONCLUSION: This systematized review helps to operationalize the concept of EV by providing a tool for evaluating and improving EV while developing new tests. Further studies with a longitudinal design can compare the predictive value of tests with higher versus lower EV-checklist scores.Key pointsQuestion: Understand the definition of EV, its dimensions and subdimensions, how EV is operationalized in neurocognitive tests and propose a checklist for the EV attributes of neurocognitive tests.Findings: The primary findings were that representativeness and generalization are the main dimensions of EV. Representativeness involves several subdimensions, whereas generalization is dependent on representativeness and is influenced by cognitive and non-cognitive factors. We provided an EV-checklist organized into six parts.Importance: The EV-checklist can be used to guide the development of ecologically valid neurocognitive tests and/or assess the EV of existing ones.Next steps: Examine the predictive value of tests that have higher EV-checklist scores.

Association between Elevated Iodine Intake and IQ among School Children in Portugal.

The goal of this work was to examine whether elevated iodine intake was associated with adverse effects on IQ among school-age children in Portugal. In a representative sample of children from the north of the country, IQ percentiles by age (assessed with Raven's Colored Progressive Matrices) were dichotomized to <50 ("below-average" IQs) and ≥50. Morning urine iodine concentrations, corrected for creatinine, were dichotomized to <250 µg/g and ≥250 µg/g, according to the European Commission/Scientific Committee on Food's tolerable upper level of daily iodine intake for young children. Data were examined with Chi-square tests, logistic regression, and GLM univariate analysis. The sample (N = 1965) was classified as generally iodine-adequate (median urinary iodine concentration = 129 µg/L; median iodine-to-creatinine ratio = 126 µg/g) according to the WHO's criteria. A greater proportion of children in the ≥250 µg/g group had below-average IQs, compared to children with less than 250 µg/g (p = 0.037), despite a sizable (though non-significant) proportion of children in the less-than-250 µg/g group also presenting below-average IQs, at the bottom of the iodine distribution (<50 µg/g). The proportion of below-average IQs increased with increasingly elevated iodine concentrations (p = 0.047). The association remained significant after the adjustment for confounders, with the elevated iodine group showing increased odds of having below-average IQs when compared with the non-elevated iodine group (OR 1.55; 95% CI 1.11−2.17; p = 0.011). Consistently, the former group presented a lower mean IQ than the latter (p = 0.006). High iodine intake was associated with lower IQs even in a population classified as iodine-adequate. These results bear on child cognition and on initiatives involving iodine supplementation.

Management of plant central metabolism by SnRK1 protein kinases.

SUCROSE NON-FERMENTING1 (SNF1)-RELATED KINASE 1 (SnRK1) is an evolutionarily conserved protein kinase with key roles in plant stress responses. SnRK1 is activated when energy levels decline during stress, reconfiguring metabolism and gene expression to favour catabolism over anabolism, and ultimately to restore energy balance and homeostasis. The capacity to efficiently redistribute resources is crucial to cope with adverse environmental conditions and, accordingly, genetic manipulations that increase SnRK1 activity are generally associated with enhanced tolerance to stress. In addition to its well-established function in stress responses, an increasing number of studies implicate SnRK1 in the homeostatic control of metabolism during the regular day-night cycle and in different organs and developmental stages. Here, we review how the genetic manipulation of SnRK1 alters central metabolism in several plant species and tissue types. We complement this with studies that provide mechanistic insight into how SnRK1 modulates metabolism, identifying changes in transcripts of metabolic components, altered enzyme activities, or direct regulation of enzymes or transcription factors by SnRK1 via phosphorylation. We identify patterns of response that centre on the maintenance of sucrose levels, in an analogous manner to the role described for its mammalian orthologue in the control of blood glucose homeostasis. Finally, we highlight several knowledge gaps and technical limitations that will have to be addressed in future research aiming to fully understand how SnRK1 modulates metabolism at the cellular and whole-plant levels.

Critical review of multisensory integration programs and proposal of a theoretical framework for its combination with neurocognitive training.

INTRODUCTION: The main purpose of this manuscript is to critically review the Multisensory Integration (MI) training programs applied to older adults, their characteristics, target sensory systems, efficacy, assessment methods, and results. We also intend to propose an integrated framework to support combined interventions of neurocognitive and sensory training. AREAS COVERED: A critical review was conducted covering the most relevant literature on the MI training programs applied to older adults. Two MI training programs applied to cognitively healthy older adults were found: (a) audio-visual temporal discrimination training and (b) simultaneity judgment training. Both led to the improvement of the MI between pre- and post-training. However, only the audio-visual temporal discrimination training led to the generalization of the improvements to another MI task. EXPERT OPINION: Considering the relationship between sensory and cognitive functioning, this review supports the potential advantages of combining MI with neurocognitive training in the rehabilitation of older adults. We suggested that this can be achieved within the framework of Branched Programmed Neurocognitive Training (BPNT). Criteria for deciding the most suitable multisensory intervention, that is, MI or Multisensory Stimulation, and general guidelines for the development of MI intervention protocols with older adults with or without cognitive impairment are provided.

The circadian clock mutant lhy cca1 elf3 paces starch mobilization to dawn despite severely disrupted circadian clock function.

Many plants, including Arabidopsis (Arabidopsis thaliana), accumulate starch in the daytime and remobilize it to support maintenance and growth at night. Starch accumulation is increased when carbon is in short supply, for example, in short photoperiods. Mobilization is paced to exhaust starch around dawn, as anticipated by the circadian clock. This diel pattern of turnover is largely robust against loss of day, dawn, dusk, or evening clock components. Here, we investigated diel starch turnover in the triple circadian clock mutant lhy cca1 elf3, which lacks the LATE ELONGATED HYPOCOTYL and the CIRCADIAN CLOCK-ASSOCIATED1 (CCA1) dawn components and the EARLY FLOWERING3 (ELF3) evening components of the circadian clock. The diel oscillations of transcripts for the remaining clock components and related genes like REVEILLE and PHYTOCHROME-INTERACING FACTOR family members exhibited attenuated amplitudes and altered peak time, weakened dawn dominance, and decreased robustness against changes in the external light-dark cycle. The triple mutant was unable to increase starch accumulation in short photoperiods. However, it was still able to pace starch mobilization to around dawn in different photoperiods and growth irradiances and to around 24 h after the previous dawn in T17 and T28 cycles. The triple mutant was able to slow down starch mobilization after a sudden low-light day or a sudden early dusk, although in the latter case it did not fully compensate for the lengthened night. Overall, there was a slight trend to less linear mobilization of starch. Thus, starch mobilization can be paced rather robustly to dawn despite a major disruption of the transcriptional clock. It is proposed that temporal information can be delivered from clock components or a semi-autonomous oscillator.

High-resolution inhibition profiling and ligand fishing for screening of nucleoside hydrolase ligands in Moringa oleifera Lamarck.

In Leishmania donovani, the causative protozoan of visceral leishmaniasis, nucleoside hydrolase enzyme (NH) is fundamental for the biosynthesis of its DNA and RNA. Therefore, LdNH is considered a potential target for the development of new leishmaniasis chemotherapy. Moringa oleifera Lamarck is a medicinal plant native to northeastern India with numerous pharmacological properties, including antileishmanial activity. Thus, this study aimed to explore the inhibitory activity of different extracts from M. oleifera leaves and flowers on LdNH. Using LdNH covalently immobilized on magnetic particles (LdNH-MPs), a novel activity assay was developed based on the direct quantification of the formed product by HPLC-DAD. This study screened 12 extracts from leaves and flowers of M. oleifera using different extraction methods. The hydroethanolic (70% ethanol) extract from flowers, obtained by infusion (FIEH) or ultrasound-assisted extraction (FUEH), exhibited respectively IC50 values of 26.2 ± 4.63 µg/mL and 4.96 ± 0.52 µg/mL. The most promising extract (FUEH) was investigated by high-resolution LdNH inhibition profiling, which showed different regions of inhibition in the biochromatogram. A ligand fishing assay was attempted to pinpoint the bioactive compounds. Experimental conditions employed in the elution step of the ligand fishing assay did not result in ligands isolation. However, the analyses of the crude extract solution and the supernatants after the incubation with the active and inactive LdNH-MPs indicated missing peaks referring to compounds selectively retained in the active LdNH-MPs incubation. The missing peaks eluted in the same region that exhibits inhibition in the high-resolution LdNH inhibition profiling. The ligands were identified by UHPLC-MS/MS as palatinose, adenosine, 3-p-coumaroylquinic acid, 4-p-coumaroylquinic acid, hyperoside, quercetin-3-O-malonyl glycoside, and kaempferol-3-O-galactoside.

Programmed neurocognitive training: proposal of a new approach.

PURPOSE: The efficacy studies of neurocognitive training have focused on the components of the programmes and general methodological questions, not presenting a rationale for the individualization of the intervention, even though this is an essential factor for efficacy. The main objective of this manuscript is to propose a framework for the individual planning of neurocognitive training sessions based on the results of neuropsychological assessment. METHODS: The proposed framework is coined Branched Programmed Neurocognitive Training (BPNT). BPNT is based on the programmed learning approach and inspired on the Luria's neurocognitive model. The main premises of this framework are the interdependence and hierarchical organization of the cognitive functions, and the individualization of neurocognitive training with multiple patient-tailored paths. RESULTS: The BPNT framework provides guidelines for planning an individualized neurocognitive training in four stages. CONCLUSIONS: The potential advantages of this proposal are discussed at various levels, including the role of reward in neurocognitive training and the potential effects of the model on the maintenance and generalization of intervention results. The BPNT framework can be used as an algorithm for the development and adaptation of paper and pencil programmes, as well as computerized rehabilitation platforms. Studies are in place to examine the feasibility of this framework.Implications for rehabilitationIndividualized neurocognitive training guided by neuropsychological assessment is most likely to be effective.Branched Programmed Neurocognitive Training (BPNT) model provides guidelines to organize the neurocognitive training based on the results of neuropsychological assessment.BPNT is based on the programmed learning model and the Luria neurocognitive model, addresses the role of reward in neurocognitive training and considers the fundamental principle of Errorless Learning.BPNT can be used as an algorithm for the development and adaptation of paper and pencil programmes and computerized rehabilitation platforms.

Assessment of the Financial Capacity in the Context of Normal and Pathological Cognitive Aging. Preliminary Analysis of the Portuguese Version of the Numerical Activities of Daily- Living- Financial (NADL-F).

Financial capacity (FC) is conceptualized as a dimension that encompasses a wide range of basic aptitudes and the capacity to judge and assess situations and make decisions according to one best interests. The Numerical Activities of Daily-Living-Financial (NADL-F) is an instrument of FC for clinical use developed in Italy. This study aims to perform a preliminary analysis on the psychometric characteristics of the Portuguese version of NADL-F. NADL-F as well as other neuropsychological instruments were administered to three groups: Healthy Control (n = 11); Mild Neurocognitive Disorder group (n = 19); Major Neurocognitive Disorder group (n = 19). NADL-F and its tasks were considered acceptable, showed good reliability for the entire sample (α = .808) and the majority of the domains correlated significantly with each other and with the total scale. Between group comparisons showed significant differences regarding all domains. Arithmetic, schooling and executive functioning accounted for 54.1% of the variance on the test. The Portuguese version of NADL-F proved to be an acceptable and valid instrument of assessing FC in the context of cognitive aging. NADL-F is an instrument that emulates real life financial situations, and it can be used in a second level of evidence in the clinical model of FC assessment.

Acaricidal Properties of Bio-Oil Derived From Slow Pyrolysis of Crambe abyssinica Fruit Against the Cattle Tick Rhipicephalus microplus (Acari: Ixodidae).

Slow pyrolysis is a process for the thermochemical conversion of biomasses into bio-oils that may contain a rich chemical composition with biotechnological potential. Bio-oil produced from crambe fruits was investigated as to their acaricidal effect. Slow pyrolysis of crambe fruits was performed in a batch reactor at 400°C and chemical composition was analyzed by gas chromatography-mass spectrometry (GC-MS). The bio-oil collected was used in bioassays with larvae and engorged females of the cattle tick Rhipicephalus microplus. Biological assays were performed using the larval packet test (LPT) and adult immersion test. The GC-MS of crambe fruit bio-oil revealed mainly hydrocarbons such as alkanes and alkenes, phenols, and aldehydes. The bio-oil in the LPT exhibited an LC90 of 14.4%. In addition, crambe bio-oil caused female mortality of 91.1% at a concentration of 15% and a high egg-laying inhibition. After ovary dissection of treated females, a significant reduction in gonadosomatic index was observed, indicating that bio-oil interfered in tick oogenesis. Considering these results, it may be concluded that slow pyrolysis of crambe fruit affords a sustainable and eco-friendly product for the control of cattle tick R. microplus.

Normative data of the Portuguese version of the Mini-Addenbrooke's Cognitive Examination.

INTRODUCTION: Mini-Addenbrooke's Cognitive Examination (M-ACE) is a screening neurocognitive test with diagnostic accuracy for mild cognitive impairment and dementia. The present study aims to determine the construct validity, concurrent and divergent validity and to determine the normative equation for the Portuguese version of M-ACE. METHOD: The sample is composed by 130 participants without any subjective complaint of memory loss and completely independent in daily life activities, recruited in health units, day care centers and religious and civic associations, from several districts of Portugal. The ACE-III, from which the M-ACE was extracted, and the Geriatric Depression Scale (GDS) were administered to all participants. RESULTS: Reliability is considered good (α = 0.844) and the item-total correlations of the M-ACE were highly significant. M-ACE showed a positive correlation with ACE-III and a negative correlation with GDS. Schooling and age were the only variables related to M-ACE performance. The obtained model from the multiple regression was significant. A normative equation was extracted from this model. CONCLUSIONS: The Portuguese version of M-ACE has solid psychometric properties enabling its clinical use. The availability of M-ACE normative equation based on a healthy sample according to age and education enables the use of a brief screening tool for cognitive functioning. M-ACE does not require formal specialized training, it is a quick test which can be an advantage, for instance, in primary health care consultations.

Impact of the SnRK1 protein kinase on sucrose homeostasis and the transcriptome during the diel cycle.

SNF1-related Kinase 1 (SnRK1) is an evolutionarily conserved protein kinase with key functions in energy management during stress responses in plants. To address a potential role of SnRK1 under favorable conditions, we performed a metabolomic and transcriptomic characterization of rosettes of 20-d-old Arabidopsis (Arabidopsis thaliana) plants of SnRK1 gain- and loss-of-function mutants during the regular diel cycle. Our results show that SnRK1 manipulation alters the sucrose and trehalose 6-phosphate (Tre6P) relationship, influencing how the sucrose content is translated into Tre6P accumulation and modulating the flux of carbon to the tricarboxylic acid cycle downstream of Tre6P signaling. On the other hand, daily cycles of Tre6P accumulation were accompanied by changes in SnRK1 signaling, leading to a maximum in the expression of SnRK1-induced genes at the end of the night, when Tre6P levels are lowest, and to a minimum at the end of the day, when Tre6P levels peak. The expression of SnRK1-induced genes was strongly reduced by transient Tre6P accumulation in an inducible Tre6P synthase (otsA) line, further suggesting the involvement of Tre6P in the diel oscillations in SnRK1 signaling. Transcriptional profiling of wild-type plants and SnRK1 mutants also uncovered defects that are suggestive of an iron sufficiency response and of a matching induction of sulfur acquisition and assimilation when SnRK1 is depleted. In conclusion, under favorable growth conditions, SnRK1 plays a role in sucrose homeostasis and transcriptome remodeling in autotrophic tissues and its activity is influenced by diel fluctuations in Tre6P levels.

Narrative review of the multisensory integration tasks used with older adults: inclusion of multisensory integration tasks into neuropsychological assessment.

Introduction: Age-related changes in sensory functioning impact the activities of daily living and interact with cognitive decline. Given the interactions between sensory and cognitive functioning, combining multisensory integration (MI) assessment with the neuropsychological assessment of older adults seems promising. This review aims to examine the characteristics and utility of MI tasks in functional and cognitive assessment of older adults, with or without neurocognitive impairment.Areas covered: A literature search was conducted following the quality assessment of narrative review criteria. Results focused on tasks of detection, discrimination, sensory illusion, temporal judgment, and sensory conflict. Studies were not consensual regarding the enhancement of MI with age, but most studies showed that older adults had an expanded time window of integration. In older adults with mild cognitive impairment or major neurocognitive disorder it was a mediating role of the magnitude of visual-somatosensory integration between neurocognitive impairment and spatial aspects of gait.Expert opinion: Recently, some concerns have been raised about how to maximize the ecological validity of the neuropsychological assessment. Since most of our activities of daily living are multisensory and older adults benefit from multisensory information, MI assessment has the potential to improve the ecological validity of the neuropsychological assessment.

Development and validation of a liquid chromatography method using UV/fluorescence detection for the quantitative determination of metabolites of the kynurenine pathway in human urine: Application to patients with heart failure.

Recent evidence indicates the relevant role of the tryptophan (TRP) metabolites in the pathophysiology of cardiovascular diseases via inflammatory and oxidative stress mechanisms. Therefore, quantification of TRP and its metabolites in biological samples can be a powerful tool to elucidate the disease mechanisms. The aim of this work was to develop and validate a liquid chromatography with ultraviolet (UV) and fluorescence detection (FD) (LCUV/FD) method for the quantification of TRP and its metabolites (L-kynurenine (KYN) and kynurenic acid (KA)) in urine samples from heart failure (HF) patients. Biochemical parameters and inflammatory markers were quantified, and data correlated with urinary concentrations of TRP and its metabolites. Optimized chromatographic conditions were achieved using a Luna® 3 µm PFP(2) analytical column, a mobile phase of 20 mM of ammonium formate in ultra-pure water (with 0.01 % of formic acid), acetonitrile and ethanol (95/2/3, v/v/v), a flow rate of 0.7 mL/min and a column oven temperature set at 25 °C. The method was validated according to the European Medicines Agency (EMA) guidelines and showed to be linear (r2 >0.99), accurate (82-116%) and precise (%RSD below 15 %). The limits of quantification varied between 50 and 125 ng/mL. The method was applied to the quantification of TRP, KYN and KA in healthy volunteers and male HF patients. The results obtained through this pilot study (small group of patients) showed a relationship between biochemical parameters, inflammatory markers and changes in the concentration of TRP, KYN and KA. The KYN/TRP and KA/KYN ratios were calculated. Results support the hypothesis that KYN/TRP ratio is related with enzymatic activity and that KA/KYN ratio can be a good neuroprotection indicator. The potential of the LCUV/FD method for the monitoring of the selected compounds in cardiac patients was also demonstrated.

Sensory stimulation programs in dementia: a systematic review of methods and effectiveness.

INTRODUCTION: Dementia is characterized by the presence of cognitive decline and can lead to sensory-perceptual alterations, compromising the functionality in activities of daily living. The main objective of this work is to review the characteristics of sensory stimulation programs in dementia and its effectiveness. AREAS COVERED: Studies were identified through a literature search, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Cochrane Collaboration Guidelines. Twenty studies were included in this review. The studies used multisensory stimulation at different stages of dementia. The results show a lack of consensus regarding frequency, duration, and number of sessions, as well as the duration of the interventions and assessment instruments used to evaluate the results. Multisensory stimulation, particularly Snoezelen, was the most widely used approach. Vision, hearing, touch, and smell were the most frequently stimulated senses. Most studies comprised pre- and post-intervention assessment, but few studies performed follow-up assessment. The interventions that revealed positive results in dementia were Snoezelen, multisensory environment other than Snoezelen, and Multi-sensory Behavior Therapy. EXPERT OPINION: This review weakly supports sensory stimulation in dementia, providing useful information for rehabilitation and future investigations.