The Edinburgh feeding evaluation in dementia (EdFED) scale: A Turkish validity and reliability study.

AIM: The present study aimed to adapt the Edinburgh Feeding Evaluation in Dementia (EdFED) Scale to Turkish. METHOD: This methodological study was reported using STARD (The STAndards for Reporting of Diagnostic Accuracy). The sample included 200 people with dementia. The data were obtained using the Personal Information Form, the Edinburgh Feeding Evaluation in Dementia Scale, and the Mini Nutritional Assessment Test. For the Turkish adaptation of the scale, construct validity (confirmatory factor analysis), criterion validity (concurrent scale validity) and reliability analysis (Cronbach's α coefficient, item-total score correlation) were performed, respectively. RESULTS: The three-factor model in the original scale was verified. The content validity index was 0.95. The Cronbach's α coefficient factors were as follows: 'Indicators of Patient Difficulty' α = 0.81, 'Patient's Need for Assistance' α = 0.79 and 'Indicators of Feeding Difficulty' α = 0.64, respectively. When the CFA fit indexes were examined, the model fit values were good. The three-factor structure was verified, compared with the original model and was compatible. No modification was needed in the model. CONCLUSIONS: The Edinburgh Feeding Evaluation in Dementia Scale Turkish version provides reliable and valid measures of feeding difficulties in people with dementia. It has satisfactory psychometric properties and is suitable to use in clinical practice. IMPLICATIONS FOR PRACTICE: Feeding is one of the most neglected subjects in caring for people with dementia. Screening is recommended to evaluate feeding and malnutrition, but, to our knowledge, there is no tool/scale to evaluate the feeding of the dementia patient in Turkish. The EdFED scale can serve healthcare professionals and caregivers as a practical tool for feeding difficulties in people with dementia.

Does transcranial direct current stimulation enhance cognitive performance in Parkinson's disease mild cognitive impairment? An event-related potentials and neuropsychological assessment study.

BACKGROUND: Parkinson's disease-mild cognitive impairment (PD-MCI) is garnering attention as a key interventional period for cognitive impairment. Currently, there are no approved treatments for PD-MCI and encouraging results of transcranial direct current stimulation (tDCS) combined with other interventions have been proposed, though the efficacy and neural mechanisms of tDCS alone have not been studied in PD-MCI yet. OBJECTIVES: The present double-blind, randomized, sham-controlled study assessed the effects of tDCS over the dorsolateral prefrontal cortex on cognitive functions via neuropsychological and electrophysiological evaluations in individuals with PD-MCI for the first time. METHOD: Twenty-six individuals with PD-MCI were administered 10 sessions of active (n = 13) or sham (n = 13) prefrontal tDCS twice a day, for 5 days. Changes were tested through a comprehensive neuropsychological battery and event-related potential recordings, which were performed before, immediately, and 1 month after the administrations. RESULTS: Neuropsychological assessment showed an improvement in delayed recall and executive functions in the active group. N1 amplitudes in response to targets in the oddball test-likely indexing attention and discriminability and NoGo N2 amplitudes in the continuous performance test-likely indexing cognitive control and conflict monitoring increased in the active group. Active stimulation elicited higher benefits 1 month after the administrations. CONCLUSION: The present findings substantiate the efficacy of tDCS on cognitive control and episodic memory, along with the neural underpinnings of cognitive control, highlighting its potential for therapeutic utility in PD-MCI. TRIAL REGISTRATION: NCT 04,171,804. Date of registration: 21/11/2019.

Associations between cardiorespiratory fitness, physical activity, intraindividual variability in behavior, and cingulate cortex in younger adults.

BACKGROUND: Higher levels of cardiorespiratory fitness (CRF) and greater amounts of physical activity have been associated with lower intraindividual variability (IIV) in executive function in children and older adults. In the present study, we examined whether CRF, measured as maximal oxygen uptake (VO2max), and daily volume of moderate-to-vigorous intensity physical activity (MVPA) were associated with IIV of reaction time during performance of the incongruent condition of the Stroop task in younger adults. Further, we examined whether the thickness of the cingulate cortex was associated with regulating variability in reaction time performance in the context of CRF or physical activity. METHODS: CRF (measured as VO2max), accelerometry-measured MVPA, Stroop performance, and thickness of the rostral anterior cingulate cortex (rACC) derived from magnetic resonance imaging data were collected in 48 younger adults (age = 24.58 ± 4.95 years, mean ± SD). Multiple regression was used to test associations between IIV during the Stroop task and CRF, MVPA, and rACC thickness. Mediation was tested using maximum likelihood estimation with bootstrapping. RESULTS: Consistent with our predictions, higher VO2max was associated with greater rACC thickness for the right hemisphere and greater daily amounts of MVPA were associated with greater rACC thickness for both the left and right hemispheres. Greater thickness of the right rACC was associated with lower IIV for the incongruent condition of the Stroop task. CRF and MVPA were not directly associated with IIV. However, we did find that IIV and both CRF and MVPA were indirectly associated via the thickness of the right rACC. CONCLUSION: These results indicate that higher CRF and greater daily volume of MVPA may be associated with lower IIV during the Stroop task via structural integrity of the rACC. Randomized controlled trials of MVPA would provide crucial information about the causal relations between these variables.

Reliability and validity of the Turkish version of the Individual-Level Abortion Stigma Scale: a methodological study.

OBJECTIVES: The aim of this study was to assess the reliability and validity of the Turkish version of the Individual-Level Abortion Stigma Scale. SETTING: Three hospitals affiliated to Public Hospitals Union General Secretariat in Manisa, a city located in Western Turkey. DESIGN: This was a methodological study. PARTICIPANTS: A total of 230 women aged 22-49 years who previously underwent abortion and volunteered to participate in the study. PRIMARY AND SECONDARY OUTCOME MEASURES: Data analysis was performed using the SPSS and LISREL software. The Content Validity Index was calculated based on the values obtained from expert opinions. In the reliability analysis, Cronbach's alpha values were calculated for the overall scale and its subscales. To test the stability of the scale over time, the scale was readministered to 30 women in the study 15 days later and the test-retest values (Pearson's correlation coefficients) were determined. In the validity analysis, the exploratory and confirmatory factor analyses were performed. In the exploratory factor analysis, the principal component analysis was performed using the varimax rotation and the factor loading of the scale was examined. Confirmatory factor analysis was performed to investigate the item-factor construct of the scale. RESULTS: The Content Validity Index was calculated as 0.86. The Cronbach's alpha values ranged between 0.83 and 0.94. The item-total correlation coefficients ranged between 0.36 and 0.72, and the test-retest reliability was 0.96 for the overall scale and its subscales (p<0.05). The total variance revealed by five factors was 75%. Confirmatory factor analysis of the scale revealed an acceptable compliance level (root mean square error of approximation=0.092, χ2/df=2.91, Goodness of Fit Index=0.831, Comparative Fit Index=0.928, p<0.001). CONCLUSIONS: The results suggest that this scale has the potential for use in research and clinical settings to measure abortion stigma among women.

HLA-A, B, C, DRB1 and DQB1 allele and haplotype frequencies in volunteer bone marrow donors from Eastern Region of Saudi Arabia.

We analyzed HLA allele and haplotype frequencies from donors from the Eastern region of Saudi Arabia. A cross-sectional study was performed on 2405 bone marrow donors from the Eastern region. HLA typing was carried out by sequencing. The most common HLA allele groups were HLA-A*02:01:01G (11.08%), A*01:01:01G (10.40%), HLA-B*52:01:01G (8.79%), B*18:01:01G (8.07%), HLA-C*04:01:01G (17.88%), C*12:03:01G (10.23%), HLA-DRB1*10:01 (14.89%), DRB1*03:01:01G (14.10%), HLA-DQB1*02:01:01G (24.53%) and DQB1*05:01:01G (20.17%). The most frequent HLA-A~ C~ B~ DRB1~ DQB1 haplotypes were HLA-A*01:03~ C*15:05:01G~ B*73:01~ DRB1*10:01:01~ DQB1*05:01:01G (3.11%) and HLA-A*01:01:01G~ C*12:02:01G~ B*52:01:01G~ DRB1*15:02:01~ DQB1*06:01:01G (2.25%). When comparing the allele and haplotype frequencies of the Eastern regions' population to those from the Central region we found significant differences in several allele frequencies including A*01:01:01G (P ≤ 0.0001), B*52:01:01G (P ≤ 0.0001), B*18:01:01G (P = 0.0001), C*12:03:01G (P < 0.0001), DRB1*10:01:01 (P < 0.0001) and DQB1*05:01:01G (P < 0.0001). Our data confirms genetic heterogeneity among the Saudi population.

Cardiorespiratory fitness is associated with enhanced hippocampal functional connectivity in healthy young adults.

Consistent associations have been found between higher cardiorespiratory fitness (CRF) and indices of enhanced brain health and function, including behavioral measures of cognition as well as neuroimaging indicators such as regional brain volume. Several studies have reported that higher CRF levels are associated with a larger hippocampus, yet associations between volume and memory or functional connectivity metrics remain poorly understood. Using a multi-modal framework, we hierarchically examine the association between CRF and hippocampal volume and resting state functional connectivity (rsFC) in younger adults, as well as their relationship between with memory function. We conducted theoretically-driven analyses with seeds in the anterior and posterior hippocampus, as well as control seeds in the caudate nucleus. We tested whether (1) hippocampal connectivity with prefrontal cortical regions was associated with CRF in an adult sample much younger than traditionally tested, (2) associations between CRF and rsFC remain significant after adjusting for volume, and (3) volume and rsFC are related to memory. We found that higher CRF levels were associated with larger anterior hippocampal volume and more positive rsFC of the anterior hippocampus to several regions including the prefrontal cortex. rsFC also accounted for significant variance in CRF, above and beyond volume. CRF can thus be independently linked to increased anterior hippocampal volume, as well as stronger hippocampal rsFC in a population much younger than those typically tested, suggesitng it is critical to maintainig multiple aspects of brain health.

A Brain Phenotype for Stressor-Evoked Blood Pressure Reactivity.

BACKGROUND: Individuals who exhibit large-magnitude blood pressure (BP) reactions to acute psychological stressors are at risk for hypertension and premature death by cardiovascular disease. This study tested whether a multivariate pattern of stressor-evoked brain activity could reliably predict individual differences in BP reactivity, providing novel evidence for a candidate neurophysiological source of stress-related cardiovascular risk. METHODS AND RESULTS: Community-dwelling adults (N=310; 30-51 years; 153 women) underwent functional magnetic resonance imaging with concurrent BP monitoring while completing a standardized battery of stressor tasks. Across individuals, the battery evoked an increase systolic and diastolic BP relative to a nonstressor baseline period (M ∆systolic BP/∆diastolic BP=4.3/1.9 mm Hg [95% confidence interval=3.7-5.0/1.4-2.3 mm Hg]). Using cross-validation and machine learning approaches, including dimensionality reduction and linear shrinkage models, a multivariate pattern of stressor-evoked functional magnetic resonance imaging activity was identified in a training subsample (N=206). This multivariate pattern reliably predicted both systolic BP (r=0.32; P<0.005) and diastolic BP (r=0.25; P<0.01) reactivity in an independent subsample used for testing and replication (N=104). Brain areas encompassed by the pattern that were strongly predictive included those implicated in psychological stressor processing and cardiovascular responding through autonomic pathways, including the medial prefrontal cortex, anterior cingulate cortex, and insula. CONCLUSIONS: A novel multivariate pattern of stressor-evoked brain activity may comprise a phenotype that partly accounts for individual differences in BP reactivity, a stress-related cardiovascular risk factor.

Physical Activity Is Associated with Reduced Implicit Learning but Enhanced Relational Memory and Executive Functioning in Young Adults.

Accumulating evidence suggests that physical activity improves explicit memory and executive cognitive functioning at the extreme ends of the lifespan (i.e., in older adults and children). However, it is unknown whether these associations hold for younger adults who are considered to be in their cognitive prime, or for implicit cognitive functions that do not depend on motor sequencing. Here we report the results of a study in which we examine the relationship between objectively measured physical activity and (1) explicit relational memory, (2) executive control, and (3) implicit probabilistic sequence learning in a sample of healthy, college-aged adults. The main finding was that physical activity was positively associated with explicit relational memory and executive control (replicating previous research), but negatively associated with implicit learning, particularly in females. These results raise the intriguing possibility that physical activity upregulates some cognitive processes, but downregulates others. Possible implications of this pattern of results for physical health and health habits are discussed.

Retinotopic information interacts with category selectivity in human ventral cortex.

Until recently, the general consensus with respect to the organization of ventral visual cortex is that early, retinotopic regions are sensitive to the spatial position of the input stimuli whereas later, higher-order regions are sensitive to the category of the input stimuli. Growing recognition of the bidirectional connectivity of the visual system has challenged this view and recent empirical evidence suggests a more interactive and graded system. Here, based on findings from functional MRI in adult observers, in which meridians and category selective regions are localized and their activation sampled, we support this latter perspective by showing that category effects are present in retinotopic cortical areas and spatial position effects are present in higher-order regions. Furthermore, the results indicate that the retinotopic and later areas are functionally connected suggesting a possible mechanism by which these seemingly disparate effects come to be intermixed in both early and later regions of the visual system.

The impact of tacrolimus on growth factors in experimental proliferative vitreoretinopathy.

PURPOSE: To investigate the effect of intravitreal tacrolimus on an animal model of proliferative vitreoretinopathy (PVR) and on growth factors implicated in its pathogenesis. METHODS: Twenty-one guinea pigs were randomly assigned to one of three groups of seven animals each: no-PVR/saline group (no PVR/intravitreal saline-injected group), PVR/saline group (dispase-induced PVR group, treated with control injections of intravitreal saline), and PVR/tacrolimus group (treatment group, dispase-induced PVR group treated with intravitreal tacrolimus injections). At the end of the experiment, eyes were enucleated and the identification of the stages of PVR was carried out. While a halves of the enucleated globes were evaluated histopathologically for PVR formation, the retinas of the other halves of globes were used for the preparation of retinal homogenates. The transforming growth factor-ß, platelet-derived growth factor, and fibroblast growth factor levels in homogenized retina tissues were measured by the enzyme-linked immunosorbent assay method. RESULTS: When assessing the average PVR stages in terms of severe PVR rates, the PVR/tacrolimus group had significantly improved when compared with the PVR/saline group. The PVR/tacrolimus group demonstrated significantly decreased levels of transforming growth factor-ß, platelet-derived growth factor, and fibroblast growth factor when compared with the PVR/saline group and also demonstrated significant improvement in epiretinal membrane formation and retinal fold in the presence of histopathologic levels. The difference in degradation of photoreceptor cells between the PVR/tacrolimus and the PVR/saline groups was not statistically significant. CONCLUSION: This study suggests that intravitreal tacrolimus application may suppress PVR development and that tacrolimus may merit investigation for the prophylaxis of PVR.

Mycoplasma pneumoniae and Chlamydia pneumoniae seropositivity in patients with age-related macular degeneration.

BACKGROUND: To determine a possible relation between Mycoplasma pneumoniae (MP) or Chlamidia pneumoniae (CP) seropositivity and age-related macular degeneration (AMD). METHODS: Sixty patients (20 wet AMD, 20 dry AMD and 20 non-AMD controls) were included in the study. Serum samples were collected for analysis of IgM and IgG antibody seropositivity for CP and MP by enzyme-linked immunosorbent assay (ELISA). Comparison of the distribution of seropositivity of these antibodies among patients with wet and dry AMD, and controls was performed. A prospective comparative clinical trial was applied. RESULTS: There was no major difference in the distribution of IgM and IgG seropositivity to CP and MP in patients with wet and dry AMD, and in controls (p > 0.05). CONCLUSIONS: We found no significant association between MP as well as CP antibody titers and AMD. It seems that MP or CP infection is not a risk factor for AMD. KEYWORDS: Mycoplasma pneumoniae; Chlamydia pneumoniae; Age-related macular degeneration; Serology.

Serum erythropoietin levels in patients with central serous chorioretinopathy.

OBJECTIVE: To evaluate the levels of erythropoietin (EPO) in the serum in patients with central serous chorioretinopathy (CSC). METHODS: An institutional comperative clinical study. The serum EPO levels were measured with the enzyme-linked immunosorbent assay (ELISA) method, of 15 patients with active CSC (Group 1), 15 patients with inactive CSC (Group 2) and 15 healthy volunteers (Group 3). Kruskal-Wallis variance analysis and Mann-Whitney U test were used for statistical analysis. RESULTS: The patient and control groups were matched for age and sex. There was no statistically significant variation with regard to age and gender among the groups (P > 0.05). The mean serum EPO concentrations in patients with active CSC (Group 1), inactive CSC (Group 2) and in healthy controls (Group 3) were 11.39 ± 3.01 mlU/mL, 11.79 ± 3.78 mlU/mL and 11.95 ± 3.27 mlU/mL, respectively. There was no significant variation among the serum EPO concentrations of the study groups (P > 0.05). CONCLUSION: These findings suggest no role of serum EPO in pathogenesis of CSC.