Background: Cognitive performance is relatively well preserved during early cognitive impairment owing to compensatory mechanisms.Methods: We explored functional near-infrared spectroscopy (fNIRS) alongside a semantic verbal fluency task (SVFT) to investigate any compensation exhibited by the prefrontal cortex (PFC) in Mild Cognitive Impairment (MCI) and mild Alzheimer's disease (AD). In addition, a group of healthy controls (HC) was studied. A total of 61 volunteers (31 HC, 12 patients with MCI and 18 patients with mild AD) took part in the present study.Results: Although not statistically significant, MCI exhibited a greater mean activation of both the right and left PFC, followed by HC and mild AD. Analysis showed that in the left PFC, the time taken for HC to achieve the activation level was shorter than MCI and mild AD (p = 0.0047 and 0.0498, respectively); in the right PFC, mild AD took a longer time to achieve the activation level than HC and MCI (p = 0.0469 and 0.0335, respectively); in the right PFC, HC, and MCI demonstrated a steeper slope compared to mild AD (p = 0.0432 and 0. 0107, respectively). The results were, however, not significant when corrected by the Bonferroni-Holm method. There was also found to be a moderately positive correlation (R = 0.5886) between the oxygenation levels in the left PFC and a clinical measure [Mini-Mental State Examination (MMSE) score] in MCI subjects uniquely.Discussion: The hyperactivation in MCI coupled with a better SVFT performance may suggest neural compensation, although it is not known to what degree hyperactivation manifests as a potential indicator of compensatory mechanisms. However, hypoactivation plus a poorer SVFT performance in mild AD might indicate an inability to compensate due to the degree of structural impairment.Conclusion: Consistent with the scaffolding theory of aging and cognition, the task-elicited hyperactivation in MCI might reflect the presence of compensatory mechanisms and hypoactivation in mild AD could reflect an inability to compensate. Future studies will investigate the fNIRS parameters with a larger sample size, and their validity as prognostic biomarkers of neurodegeneration.
ObjectivesOsteoporosis is a rapidly rising cause of concern for elderly patients. Various classes of drugs are available in the market. Bisphosphonates are considered as a first-line therapy for the prevention and treatment. Denosumab is an antiresorptive agent which is a RANK ligand inhibitor. There is a scarcity of comparison between these two classes of drugs. The aim of this study is to compare efficacy of Bisphosphonates and Denosumab in various parameters.MethodsLiterature search was done for randomized controlled trials (RCTs) comparing bisphosphonates with denosumab. RCTs with a treatment period of at least one year with a baseline bone mineral density (BMD) and bone turnover markers (BTM) and follow up values at one year were included in the study. All included studies were also analysed for complications. The study has also been registered in PROSPERO International prospective register of systematic reviews.ResultsA total of five RCTs were identified providing data on 3751 participants. In all five studies, the BMD changes at both hip and spine were statistically significant in favour of denosumab. Result was similar in three studies that studied BMD changes at the wrist. Denosumab also produced significant reduction in BTM as early as one month, but at one year there was no difference compared to the bisphosphonates. There was no statistically significant differences in the complication rates.ConclusionsThough both bisphosphonates and denosumab were effective with similar side effects, the latter was statistically superior in increasing the BMD and reducing the BTM.
Background: Alzheimer's disease (AD)'s pharmacotherapy is limited, with anecdotal reports claiming some usefulness of cold pressed coconut oil. Aims and Objectives: To study the effect of cold pressed coconut oil on cognition and behavior of AD patients who are treatment naïve or stabilized on cholinesterase inhibitors or memantine for at least 3 months with a mini-mental state examination (MMSE) score of 10-24. Materials and Methods: An investigator initiated pilot randomized controlled trial studied the effect of cold pressed coconut oil on cognition and behavior of AD patients. Minimum sample size was calculated assuming an increase of 30% in MMSE scores in the experimental group with 95% confidence interval and 80% power to be 20 at each experimental and control groups. Efficacy was measured using MMSE, clock drawing test (CDT), neuropsychiatric inventory questionnaire at baseline, 3 and 6 months, with safety profile monitored by electrocardiogram, and laboratory investigations at baseline and at 6 months. Results: 40 individuals out of 99 screened were enrolled, with no significant differences in cognitive level between the intervention and control group at baseline. At 6 months, the control group showed significant (P = 0.035) improvement in CDT. Diarrhea, the most common adverse event caused high dropout in intervention group. Conclusion: Cold pressed coconut oil did not improve cognition or behavior in AD patients.
Background: To describe various measures for estimation of effect size, how it can be calculated and the scenarios in which each measures of effect size can be applied. Methods: The researchers can display the effect size measures in research articles which evaluate the difference between the means of continuous variables in different groups or the difference in proportions of outcomes in different groups of individuals. When p-value alone is displayed in a research article, without mentioning the effect size, reader may not get the correct pictures regarding the effect or role of independent variable on the outcome variable. Results: Effect size is a statistical concept that measures the actual difference between the groups or the strength of the relationship between two variables on a numeric scale. Conclusion: Effect size measures in scientific publications can communicate the actual difference between groups or the estimate of association between the variables, not just if the association or difference is statistically significant. The researchers can make their findings more interpretable, by displaying a suitable measure of effect size. Effect size measure can help the researchers to do meta-analysis by combining the data from multiple research articles.
||ABSTRACT Background: The availability and the use of electronic devices among the students of higher education have been continuing to grow. The devices connect the users to the world instantly, allow access to information, and enable interactivity with others. The uses of these devices are playing an important role, especially in their academic lives. Aims and Objectives: To identify the types of devices used for the students, the purpose of their use, and its influence on their academic performances. Materials and Methods: A questionnaire was developed, and its content validity was tested by a survey expert. About 300 questionnaires were later distributed among the available year-I, -II, and -III students, and 230 completed questionnaires were collected back from the participants. The data collected were inserted in the SPSS (version 17.0) program and analyzed accordingly. Results: Descriptive analysis showed that 71.7% of the respondents were female students; 68.7% were in 20-21 age groups; and 42.2% were from year I, 42.6% from year II, and the rest from year III. A total of 65.7% of the respondents admitted that they used to use electronic devices in the classroom, and 89.6% of which use a smartphone. Among the smartphone users, about 48% scored 465% marks in their last examination. Conclusion: It has been found that the students' performance was directly associated with the use of electronic devices for academic purposes. In this study, students' learning behavior with electronic devices, especially smartphones, was explored, and the data indicated that they want more access to the academic-friendly devices. The smart uses of electronic devices, therefore, help to improve the academic performance of the students.
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