PLOS ONE: [sortOrder=DATE_NEWEST_FIRST, sort=Date, newest first, q=subject:"Neurology"]PLOShttps://journals.plos.org/plosone/webmaster@plos.orgaccelerating the publication of peer-reviewed sciencehttps://journals.plos.org/plosone/search/feed/atom?sortOrder=DATE_NEWEST_FIRST&sort=Date,+newest+first&unformattedQuery=subject:%22Neurology%22All PLOS articles are Open Access.https://journals.plos.org/plosone/resource/img/favicon.icohttps://journals.plos.org/plosone/resource/img/favicon.ico2024-03-29T08:40:28ZFactors related to a sense of economic insecurity among older adults who participate in social activitiesYuriko InoueHisae NakataniIchie OnoXuxin Peng10.1371/journal.pone.03012802024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Yuriko Inoue, Hisae Nakatani, Ichie Ono, Xuxin Peng</p>
Japan has the highest life expectancy worldwide. Older adults who experience economic insecurity may refrain from seeking medical consultation or using long-term care insurance, and these behaviors may increase the incidence and progression of frailty. This study conducted a cross-sectional survey to identify factors related to a sense of economic insecurity among older adults who participate in social activities, and identified support measures. In total, 1,351 older adults aged ≥65 years who had participated in social activities voluntarily completed an anonymous self-administered questionnaire. The questionnaire encompassed their physical, cognitive, social, and psychological conditions, and economic insecurity. We performed univariate analysis considering a sense of economic insecurity as the dependent variable, and conducted multiple logistic regression analysis (forced entry method) considering the independent variables with p<0.1 as the covariates. Among the 872 filled questionnaires, 717 were analyzed as they had no missing data with respect to the responses to survey questions (valid response rate was 53.1%). Analysis results showed that 43.6% of the older adults had a sense of economic insecurity, which was most common among those aged 75–84 years, accounting for 47.3%, followed by those aged 65–74 years accounting for 44.1%, and those aged ≥85 years accounting for 31.5% (p<0.05). The sense of economic insecurity was not associated with physical conditions, subjective symptoms of dementia, or social conditions; however, it grew with increased loneliness (OR: 1.71, 1.002–2.92, p = 0.049) and decreased with an increased subjective sense of well-being (OR: 0.86, 0.81–0.92, <0.001). Economic insecurity among older adults was not associated with physical, cognitive, or social aspects, as reported in previous studies. The survey respondents constituted older adults who participate in social activities. Maintaining interactions within the community, even in old age, may prevent loneliness and improve subjective health.The relationship between autistic traits, expressiveness, readability and social perceptionsRabi Samil AlkhaldiElizabeth SheppardZack EllerbyEmily Rachel Reed BurdettPeter Mitchell10.1371/journal.pone.03010032024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Rabi Samil Alkhaldi, Elizabeth Sheppard, Zack Ellerby, Emily Rachel Reed Burdett, Peter Mitchell</p>
This study investigated the relationship between autistic traits, expressiveness, readability (both actual and perceived), social favourability, and likability. Sixty participants designated as ‘targets’ were video recorded in a range of social scenarios and their autistic traits were measured using the Autism Spectrum Quotient. The videos were then shown to 106 new participants designated ‘perceivers’, who were split into three groups to make judgments related to readability, expressiveness, and social favourability respectively. Mediation analyses revealed that autistic traits negatively impacted both perceived likeability and social favourability, mediated by lowered expressiveness. Autistic traits also directly impacted readability, which was not mediated by expressiveness. The findings show how the level of autistic traits of a target can influence how they are socially perceived by others.Does attitude importance moderate the effects of person-first language? A registered reportSandy SchumannHazem Zohny10.1371/journal.pone.03008792024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Sandy Schumann, Hazem Zohny</p>
Previous research has demonstrated that exposure to outgroup descriptions that use person-first, as compared to identity-first, language can attenuate negative stereotypes or prejudice and enhance support for policies that seek to advance outgroup rights. However, those benefits of person-first language may not apply to all social groups equally. The present study examines a boundary condition of the effects of person-first language. Specifically, we postulate that person-first language reduces the stigmatization of outgroups to a lesser degree if individuals hold more important negative attitudes towards the respective communities. We will test this hypothesis in a two-factorial 2 (target group) x 2 (descriptor) online experiment that includes a control group and for which we will recruit a general-population sample (<i>N</i> = 681). Stereotyping, dehumanization, as well as negative affect and behavioral intentions towards two outgroups will be compared: people with a physical disability/the physically disabled (i.e., negative attitudes are expected to be less important) and people who have committed a violent crime/violent criminals (i.e., negative attitudes are expected to be more important). Our findings will bear implications for understanding when language use could influence public opinion of different social groups. Additionally, the research can inform the development of more effective communication policies to promote inclusion and reduce stigma.Self-reported factors associated with community ambulation after stroke: The Canadian Longitudinal Study on AgingRuth BarclaySandra C. WebberJacquie RipatScott NowickiRobert Tate10.1371/journal.pone.02995692024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Ruth Barclay, Sandra C. Webber, Jacquie Ripat, Scott Nowicki, Robert Tate</p>
Community ambulation is frequently limited for people with stroke. It is, however, considered important to people with stroke. The objectives were to identify factors associated with self-reported community ambulation in Canadians aged 45+ with stroke and to identify factors associated with community ambulation specific to Canadian males and to Canadian females with stroke. Data were utilized from the Canadian Longitudinal Study on Aging Tracking Cohort. Multivariate logistic regression models were developed for community ambulation. Mean age was 68 (SE 0.5) years (45% female). In the final community ambulation model (n = 855), factors associated with being less likely to ‘walk outdoors sometimes or often’ included difficulty or being unable to walk 2–3 blocks (decreased endurance) vs. no difficulty. Being more likely to walk outdoors was associated with ‘better weather’ months and being 55–64 years of age vs 75–85. Differences were noted between the models of only males and only females. Decreased walking endurance is associated with a decreased likelihood of walking in the community—a factor that can be addressed by rehabilitation professionals and in community based programs.Outcome benefits of upfront cytoreductive nephrectomy for patients with metastatic renal cell carcinoma: An analysis of the TriNetX databaseGu-Shun LaiJian-Ri LiShian-Shiang WangChuan-Shu ChenChun-Kuang YangChia-Yen LinSheng-Chun HungKun-Yuan ChiuShun-Fa Yang10.1371/journal.pone.02991022024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Gu-Shun Lai, Jian-Ri Li, Shian-Shiang Wang, Chuan-Shu Chen, Chun-Kuang Yang, Chia-Yen Lin, Sheng-Chun Hung, Kun-Yuan Chiu, Shun-Fa Yang</p>
Background <p>The role of upfront cytoreductive nephrectomy remains debatable in the present era of tyrosine kinase inhibitors and immune checkpoint inhibitors. Here, we aimed to evaluate the outcomes of metastatic renal cell carcinoma patients treated with upfront CN and modern systemic therapies.</p> Methods <p>Using the TriNetX network database, we identified patients, in the period from 2008 to 2022, who were diagnosed with metastatic renal cell carcinoma, receiving first-line systemic therapies with tyrosine kinase inhibitors or immune checkpoint inhibitors. Their overall survivals were evaluated using the Kaplan-Meier method as well as multivariable regressions.</p> Results <p>We identified 11,094 patients with metastatic renal cell carcinoma. Of them, 2,914 (43%) patients in the tyrosine kinase inhibitor cohort (n = 6,779), and 1,884 (43.7%) in the immune checkpoint inhibitors cohort (n = 4315) underwent upfront cytoreductive nephrectomy. Those receiving upfront cytoreductive nephrectomy showed survival advantages with either tyrosine kinase inhibitor (Hazard ratio 0.722, 95% Confidence interval 0.67–0.73, p<0.001) or immune checkpoint inhibitors (Hazard ratio 65.1, 95% Confidence interval 0.59–0.71, p<0.001). In multivariable analysis, upfront cytoreductive nephrectomy was a factor for improved OS in both cohorts: tyrosine kinase inhibitors (Hazard ratio 0.623, 95% Confidence interval 0.56–0.694, p<0.001) and immune checkpoint inhibitors cohort (Hazard ratio 0.688, 95% Confidence interval 0.607–0.779, p<0.001).</p> Conclusions <p>Upfront cytoreductive nephrectomy was associated with an improved overall survival for patients with metastatic renal cell carcinoma receiving either first-line tyrosine kinase inhibitors or immune checkpoint inhibitors. Our results support a clinical role of upfront cytoreductive nephrectomy in the modern era.</p>Safety and efficacy of antioxidant therapy in children and adolescents with attention deficit hyperactivity disorder: A systematic review and network meta-analysisPeike ZhouXiaohui YuTao SongXiaoli Hou10.1371/journal.pone.02969262024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by Peike Zhou, Xiaohui Yu, Tao Song, Xiaoli Hou</p>
Objective <p>To systematically evaluate the safety and efficacy of antioxidant therapy in children and adolescents with attention deficit hyperactivity disorder (ADHD).</p> Methods <p>Randomized controlled trials and prospective studies on antioxidant therapy in children and adolescents with ADHD were searched in PubMed, Embase, and Cochrane Library from the inception of databases to November 12, 2022. Two investigators independently screened the literature, extracted data, and evaluated the quality of the included studies. Network meta-analysis (PROSPERO registration number CRD 42023382824) was carried out by using R Studio 4.2.1.</p> Results <p>48 studies involving 12 antioxidant drugs (resveratrol, pycnogenol, omega-3, omega-6, quercetin, phosphatidylserine, almond, vitamin D, zinc, folic acid, ginkgo biloba, Acetyl-L-carnitine) were finally included, with 3,650 patients. Network meta-analysis showed that omega-6 (0.18), vitamin D (0.19), and quercetin (0.24) were the top three safest drugs according to SUCRA. The omega-3 (SUCRA 0.35), pycnogenol (SUCRA 0.36), and vitamin D (SUCRA 0.27) were the most effective in improving attention, hyperactivity, and total score of Conners’ parent rating scale (CPRS), respectively. In terms of improving attention, hyperactivity, and total score of Conners’ teacher rating scale (CTRS), pycnogenol (SUCRA 0.32), phosphatidylserine+omega-3 (SUCRA 0.26), and zinc (SUCRA 0.34) were the most effective, respectively. In terms of improving attention, hyperactivity and total score of ADHD Rating Scale-Parent, the optimal agents were phosphatidylserine (SUCRA 0.39), resveratrol+MPH (SUCRA 0.24), and phosphatidylserine (SUCRA 0.34), respectively. In terms of improving attention, hyperactivity and total score of ADHD Rating Scale-Teacher, pycnogenol (SUCRA 0.32), vitamin D (SUCRA 0.31) and vitamin D (SUCRA 0.18) were the optimal agents, respectively. The response rate of omega-3+6 was the highest in CGI (SUCRA 0.95) and CPT (SUCRA 0.42).</p> Conclusion <p>The rankings of safety and efficacy of the 12 antioxidants vary. Due to the low methodological quality of the included studies, the probability ranking cannot fully explain the clinical efficacy, and the results need to be interpreted with caution. More high-quality studies are still needed to verify our findings.</p>What influences stroke survivors with physical disabilities to be physically active? A qualitative study informed by the Theoretical Domains FrameworkL. K. KwahK. DoshiD. A. De SilvaW. M. NgS. Thilarajah10.1371/journal.pone.02924422024-03-28T14:00:00Z2024-03-28T14:00:00Z<p>by L. K. Kwah, K. Doshi, D. A. De Silva, W. M. Ng, S. Thilarajah</p>
Background <p>Although the benefits of regular physical activity (PA) after stroke are well established, many stroke survivors do not achieve recommended PA levels. To date, studies exploring determinants to PA have not used a behaviour change theory and focused on stroke survivors with physical disabilities. As a precursor to an intervention development study, we aimed to use the Theoretical Domains Framework (TDF) to identify factors influencing PA in stroke survivors with physical disabilities in Singapore.</p> Methods <p>Between November 2021 and January 2022, we conducted interviews with 19 community-dwelling stroke survivors with a weak arm and/or leg. An interview guide based on the TDF was developed. We analysed the data deductively by coding interview transcripts into the theoretical domains of the TDF, and then inductively by generating themes and belief statements. To identify relevant TDF domains, we prioritised the domains based on the frequencies of the belief statements, presence of conflicting belief statements and evidence of strong belief statements.</p> Results <p>Eight of the 14 TDF domains were relevant, and included environmental context and resources, knowledge, social influences, emotion, reinforcement, behavioural regulation, skills and beliefs about capabilities. The lack of access, suitable equipment and skilled help often limited PA participation at public fitness spaces such as parks, gyms and swimming pools (environmental context and resources). While a few stroke survivors expressed that they had the skills to engage in regular PA, most expressed not knowing how much and how hard to work, which exercises to do, which equipment to use and how to adapt exercises and equipment (knowledge and skills). This often left them feeling afraid to try new activities or venture out to new places for fear of the unknown or adverse events (e.g., falls) (emotion). For some, doing the activities in a group encourage them to get out and engage in PA (social influences).</p> Conclusions <p>In stroke survivors with physical disabilities, environmental context and resources had a significant influence on PA participation, and this often had a spill over effect into other domains. Our results inform a complex behaviour change intervention to improve PA after stroke, and has implications for intervention design for people with physical disabilities.</p>Difficulties and challenges experienced by nurses in eldercare institutions in Albania: A qualitative content analysisNertila PodgoricaEmiljano PjetriAndreas W. Müller (M. A.)Susanne Perkhofer10.1371/journal.pone.03007742024-03-27T14:00:00Z2024-03-27T14:00:00Z<p>by Nertila Podgorica, Emiljano Pjetri, Andreas W. Müller (M. A.), Susanne Perkhofer</p>
Introduction <p>The global and Albanian populations of elderly people are steadily increasing. It is estimated that the number of elderly adults requiring care in Albania will rise from 90.9 thousand to 130.4 thousand by 2030. Despite the envisaged increase in the number and life expectancy of the elderly population in Albania, which will result in an increased demand for nursing care, little is known about the difficulties and challenges that nurses face while providing care for elderly Albanian individuals.</p> Aim <p>To explore the difficulties and challenges nurses experience while caring for elderly people in Albanian eldercare institutions.</p> Methods <p>The study employed a qualitative design using purposive sampling of 20 nurses in 8 eldercare institutions who participated in face-to-face semi-structured interviews. The audio-recorded interviews were transcribed and subsequently subjected to analysis using Graneheim and Lundman’s qualitative conventional content analysis. Data analysis was supported by the qualitative data analysis software MAXQDA 2020. The reporting of this study followed the consolidated criteria for reporting qualitative research (COREQ) checklist.</p> Results <p>Five key categories emerged from data analysis: (1) professional difficulties, (2) educational difficulties, (3) relationship challenges, (4) increased mental stress, and (5) participation in advocacy. This study showed that nursing staff experienced many barriers, challenges, and unmet needs when implementing care for elderly people in long-term care facilities.</p> Conclusion <p>The findings indicate that nurses working in eldercare institutions faced significant challenges in caring for elderly people. Nurses need more legal, financial, educational, and emotional support. The study indicates that more organizational and national support is necessary for nursing staff to care for elderly people in eldercare Albanian institutions properly. Eldercare institution leaders need to recognize the importance of their role in overcoming the barriers and providing adequate support for their staff in caring for elderly people.</p>How to provide existential and spiritual support to people with mild to moderate dementia and their loved ones. A pilot studyMarc HaufeSaskia TeunissenCarlo Leget10.1371/journal.pone.02987832024-03-27T14:00:00Z2024-03-27T14:00:00Z<p>by Marc Haufe, Saskia Teunissen, Carlo Leget</p>
Background <p>People with mild to moderate dementia and their loved ones may experience strong existential and spiritual challenges due to the disease. People with dementia could therefore benefit greatly from ongoing conversational support. Within the literature and in supportive practice, there are very few tools that help professionals provide this type of support. Professionals may therefore be unaware of, or uncertain of, how support can be given.</p> Objective <p>To develop and test support approaches that may enable professionals to better conduct conversations with attention for existential and spiritual issues.</p> Methods <p>Participatory action research was conducted with dementia care professionals who spoke to 62 clients and 36 loved ones. Research consisted of two cycles of analyzing support, formulating strategies to try, testing and reflecting on the success of these actions and formulating new ones. The Diamond model for existential and spiritual issues regarding mild to moderate dementia, developed in previous research, was used as a framework.</p> Results <p>Five types of approaches, corresponding to the five fundamental polarities within the basic framework, were found to be helpful in alleviating tensions and bolstering strengths. For issues of self-confidence and -worth, an approach of <i>exploring the felt self</i> was developed; for issues of capacity and adaptability, an <i>exploring daily routines</i> approach; for issues of security and loss, an <i>exploring a trinity of needs</i> approach; for issues of burden and enrichment, an <i>exploring memory</i> approach; and for issues of faith and meaning, an <i>exploring ones’ predicament</i> approach. When exploring these approaches, participants found sets and sequencing of questions and prompts to be helpful and transformative.</p> Conclusion <p>Professionals can use the Diamond framework to provide conversational support to alleviate tension, enhance meaning and bolster strength for clients and loved ones.</p>Breastfeeding, cognitive ability, and residual confounding: A comment on studies by Pereyra-Elìas et al.Kimmo SorjonenGustav NilsonneMichael IngreBo Melin10.1371/journal.pone.02972162024-03-27T14:00:00Z2024-03-27T14:00:00Z<p>by Kimmo Sorjonen, Gustav Nilsonne, Michael Ingre, Bo Melin</p>
Recent studies found positive effects of breastfeeding on the child’s cognitive ability and educational outcomes even when adjusting for maternal cognitive ability in addition to a large number of other potential confounders. The authors claimed an important role of breastfeeding for the child’s cognitive scores. However, it is well known that error in the measurement of confounders can leave room for residual confounding. In the present reanalyses, we found incongruent effects indicating simultaneous increasing and decreasing effects of breastfeeding on the child’s cognitive ability and educational outcomes. We conclude that findings in the reanalyses may have been due to residual confounding due to error in the measurement of maternal cognitive ability. Consequently, it appears premature to assume a genuine increasing effect of breastfeeding on the child’s cognitive ability and educational outcomes and claims in this regard may be challenged.Bayesian-knowledge driven ontologies: A framework for fusion of semantic knowledge under uncertainty and incompletenessEugene Santos Jr.Jacob JurmainAnthony Ragazzi10.1371/journal.pone.02968642024-03-27T14:00:00Z2024-03-27T14:00:00Z<p>by Eugene Santos Jr., Jacob Jurmain, Anthony Ragazzi</p>
The modeling of uncertain information is an open problem in ontology research and is a theoretical obstacle to creating a truly semantic web. Currently, ontologies often do not model uncertainty, so stochastic subject matter must either be normalized or rejected entirely. Because uncertainty is omnipresent in the real world, knowledge engineers are often faced with the dilemma of performing prohibitively labor-intensive research or running the risk of rejecting correct information and accepting incorrect information. It would be preferable if ontologies could explicitly model real-world uncertainty and incorporate it into reasoning. We present an ontology framework which is based on a seamless synthesis of description logic and probabilistic semantics. This synthesis is powered by a link between ontology assertions and random variables that allows for automated construction of a probability distribution suitable for inferencing. Furthermore, our approach defines how to represent stochastic, uncertain, or incomplete subject matter. Additionally, this paper describes how to fuse multiple conflicting ontologies into a single knowledge base that can be reasoned with using the methods of both description logic and probabilistic inferencing. This is accomplished by using probabilistic semantics to resolve conflicts between assertions, eliminating the need to delete potentially valid knowledge and perform consistency checks. In our framework, emergent inferences can be made from a fused ontology that were not present in any of the individual ontologies, producing novel insights in a given domain.Dysregulation of LINC00324 promotes poor prognosis in patients with gliomaXin JinJiandong ZhuHaoyun YuShengjun ShiKecheng ShenJingyu GuZiqian YinZhengquan YuJiang Wu10.1371/journal.pone.02980552024-03-26T14:00:00Z2024-03-26T14:00:00Z<p>by Xin Jin, Jiandong Zhu, Haoyun Yu, Shengjun Shi, Kecheng Shen, Jingyu Gu, Ziqian Yin, Zhengquan Yu, Jiang Wu</p>
Background <p>LINC00324 is a long-stranded non-coding RNA, which is aberrantly expressed in various cancers and is associated with poor prognosis and clinical features. It involves multiple oncogenic molecular pathways affecting cell proliferation, migration, invasion, and apoptosis. However, the expression, function, and mechanism of LINC00324 in glioma have not been reported.</p> Material and methods <p>We assessed the expression of LINC00324 of LINC00324 in glioma patients based on data from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) to identify pathways involved in LINC00324-related glioma pathogenesis.</p> Results <p>Based on our findings, we observed differential expression of LINC00324 between tumor and normal tissues in glioma patients. Our analysis of overall survival (OS) and disease-specific survival (DSS) indicated that glioma patients with high LINC00324 expression had a poorer prognosis compared to those with low LINC00324 expression. By integrating clinical data and genetic signatures from TCGA patients, we developed a nomogram to predict OS and DSS in glioma patients. Gene set enrichment analysis (GSEA) revealed that several pathways, including JAK/STAT3 signaling, epithelial-mesenchymal transition, STAT5 signaling, NF-κB activation, and apoptosis, were differentially enriched in glioma samples with high LINC00324 expression. Furthermore, we observed significant correlations between LINC00324 expression, immune infiltration levels, and expression of immune checkpoint-related genes (HAVCR2: r = 0.627, P = 1.54e-77; CD40: r = 0.604, P = 1.36e-70; ITGB2: r = 0.612, P = 6.33e-7; CX3CL1: r = -0.307, P = 9.24e-17). These findings highlight the potential significance of LINC00324 in glioma progression and suggest avenues for further research and potential therapeutic targets.</p> Conclusion <p>Indeed, our results confirm that the LINC00324 signature holds promise as a prognostic predictor in glioma patients. This finding opens up new possibilities for understanding the disease and may offer valuable insights for the development of targeted therapies.</p>A deeply supervised adaptable neural network for diagnosis and classification of Alzheimer’s severity using multitask feature extractionMohsen AhmadiDanial JavaheriMatin KhajaviKasra DaneshJunbeom Hur10.1371/journal.pone.02979962024-03-26T14:00:00Z2024-03-26T14:00:00Z<p>by Mohsen Ahmadi, Danial Javaheri, Matin Khajavi, Kasra Danesh, Junbeom Hur</p>
Alzheimer’s disease is the most prevalent form of dementia, which is a gradual condition that begins with mild memory loss and progresses to difficulties communicating and responding to the environment. Recent advancements in neuroimaging techniques have resulted in large-scale multimodal neuroimaging data, leading to an increased interest in using deep learning for the early diagnosis and automated classification of Alzheimer’s disease. This study uses machine learning (ML) methods to determine the severity level of Alzheimer’s disease using MRI images, where the dataset consists of four levels of severity. A hybrid of 12 feature extraction methods is used to diagnose Alzheimer’s disease severity, and six traditional machine learning methods are applied, including decision tree, K-nearest neighbor, linear discrimination analysis, Naïve Bayes, support vector machine, and ensemble learning methods. During training, optimization is performed to obtain the best solution for each classifier. Additionally, a CNN model is trained using a machine learning system algorithm to identify specific patterns. The accuracy of the Naïve Bayes, Support Vector Machines, K-nearest neighbor, Linear discrimination classifier, Decision tree, Ensembled learning, and presented CNN architecture are 67.5%, 72.3%, 74.5%, 65.6%, 62.4%, 73.8% and, 95.3%, respectively. Based on the results, the presented CNN approach outperforms other traditional machine learning methods to find Alzheimer severity.Clinical gait analysis using video-based pose estimation: Multiple perspectives, clinical populations, and measuring changeJan StenumMelody M. HsuAlexander Y. PantelyatRyan T. Roemmich10.1371/journal.pdig.00004672024-03-26T14:00:00Z2024-03-26T14:00:00Z<p>by Jan Stenum, Melody M. Hsu, Alexander Y. Pantelyat, Ryan T. Roemmich</p>
Gait dysfunction is common in many clinical populations and often has a profound and deleterious impact on independence and quality of life. Gait analysis is a foundational component of rehabilitation because it is critical to identify and understand the specific deficits that should be targeted prior to the initiation of treatment. Unfortunately, current state-of-the-art approaches to gait analysis (e.g., marker-based motion capture systems, instrumented gait mats) are largely inaccessible due to prohibitive costs of time, money, and effort required to perform the assessments. Here, we demonstrate the ability to perform quantitative gait analyses in multiple clinical populations using only simple videos recorded using low-cost devices (tablets). We report four primary advances: 1) a novel, versatile workflow that leverages an open-source human pose estimation algorithm (OpenPose) to perform gait analyses using videos recorded from multiple different perspectives (e.g., frontal, sagittal), 2) validation of this workflow in three different populations of participants (adults without gait impairment, persons post-stroke, and persons with Parkinson’s disease) via comparison to ground-truth three-dimensional motion capture, 3) demonstration of the ability to capture clinically relevant, condition-specific gait parameters, and 4) tracking of within-participant changes in gait, as is required to measure progress in rehabilitation and recovery. Importantly, our workflow has been made freely available and does not require prior gait analysis expertise. The ability to perform quantitative gait analyses in nearly any setting using only low-cost devices and computer vision offers significant potential for dramatic improvement in the accessibility of clinical gait analysis across different patient populations.Interventions to address mealtime support needs in dementia: A scoping reviewLígia PassosJoão TavaresMelissa BatchelorDaniela Figueiredo10.1371/journal.pone.03009872024-03-25T14:00:00Z2024-03-25T14:00:00Z<p>by Lígia Passos, João Tavares, Melissa Batchelor, Daniela Figueiredo</p>
The decrease in cognitive and physical ability among people with dementia can significantly affect eating performance, resulting in mealtime support needs that could lead to inadequate oral intake, weight loss, malnutrition, and reduced functionality in activities of daily living. This scoping review aimed to identify and summarize available research literature on mealtime interventions for people with dementia, and their impact on older people with dementia living in a residential care setting, care staff, and care context/environment. A scoping review of available research published in English, French, Portuguese, or Spanish, was conducted according to the methodology established by The Joanna Briggs Institute. The search was conducted between November 2022 and February 2023 in the following databases: MEDLINE, Web of Science, Scopus, CINAHL Complete, and SciELO. A total of 275 articles were retrieved, of which 33 studies were selected according to inclusion criteria. The interventions were classified into four general categories: environmental, mealtime assistance, staff training, and multicomponent. Most studies demonstrated effectiveness in increasing oral intake and improving behaviors such as agitation and aggression in people with dementia. The impact of interventions on care staff was linked to greater knowledge and attitudes towards mealtime support needs. There is a lack of reporting on the impact of interventions on the care context/environment. Most interventions examined the effects exclusively on residents, focusing on their oral intake and behavioral patterns, particularly agitation among individuals with dementia. However, it is crucial to conduct studies that evaluate the impact on administrators, to comprehend the viewpoints of various hierarchical levels within an organization regarding challenges associated with mealtime. The findings of this scoping review can support the development of new supportive programs, or strategies to improve mealtime experience with positive impact according to the reality and needs of each person or institution.