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This work focuses on the analysis of a singular case of brick vault by slices from the Aurelian Walls in Rome. The study is based on an accurate survey carried out through automated photogrammetry. This analysis aims to determine the geometry of the vault and compare it with the theoretical model of its type., Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. This paper is part of the research project "The construction of brick vaults by slices. Historical uses and current possibilities" PID2020-116191 GB-I00, funded by MCIN/AEI/https://doi.org/10.13039/501100011033

The aim of this study was to propose a hypothetical model of leadership in the context of digital health services. The study consisted of two phases: phase I aimed to clarify and define the concept of leadership and describe leadership in the context of digital health services; phase II proposed a hypothetical model of leadership in the context of digital health services, based on the results of phase I. In phase I, a conceptual framework for the hypothetical model of leadership in the context of digital health services was created using the Walker and Avant concept analysis model and qualitative studies. First, the concept of leadership in the context of digital health services was clarified and defined. A total of 23 scientific papers were analysed. Based on the concept analysis, leadership attributes were identified concerning leaders’ behaviour, roles, and qualities. Antecedents were related to IT skills and competences, information and tools, understanding the complexity of care systems, and possessing a sufficient education level. Finally, consequences were related to organization, professionals, and patients and their care. Second, two qualitative descriptive studies were conducted. The data were collected using individual interviews (n=21) in primary care and focus group interviews (n=6) in specialized medical care with healthcare leaders (n=20). Data were analysed using inductive and deductive-inductive content analyses. Based on the first qualitative sub-study, six main categories were formed, namely strategic leadership, operative leadership, transformational leadership, leading one’s own and employees’ digital competence, remote leadership, and leading collaboration and co-creation. The second qualitative sub-study identified traits, cognition, affects, and behaviours concerning e-leadership. In phase II, a hypothetical model of leadership in the context of digital health services was proposed. This hypothetical model summarized the results of phase I and proposed antecedents, attributes, and consequences of leadership in the context of digital health services. The attributes of leadership were related to traits and qualities, roles, behaviours, affects, and cognition. This study provides a novel and comprehensive view of leadership in the context of digital health services. The hypothetical model can be utilized in advancing healthcare digitalization, developing education for healthcare leaders, and advancing future leadership and digitalization research. Tiivistelmä Tämän tutkimuksen tarkoituksena oli muodostaa hypoteettinen malli johtajuudesta digitaalisten terveyspalveluiden kontekstissa. Tutkimus sisälsi kaksi vaihetta. Ensimmäisen vaiheen tarkoituksena oli määritellä johtajuuden käsite sekä kuvata johtajuutta digitaalisten terveyspalvelujen kontekstissa. Toisessa vaiheessa muodostettiin hypoteettinen malli johtajuudesta digitaalisen terveyden kontekstissa perustuen aikaisemman vaiheen tuloksia. Vaiheessa I tunnistettiin ja määriteltiin johtajuuden käsite digitaalisten terveyspalvelujen kontekstissa käyttäen Walkerin ja Avantin käsiteanalyysia. Yhteensä 23 tieteellistä artikkelia analysoitiin. Käsiteanalyysin perusteella johtajuuden piirteisiin sisältyivät johtajien käyttäytymistä, rooleja ja ominaisuuksia. Edellytykset liittyivät informatiikan osaamiseen, tietoon ja työvälineisiin, palvelujärjestelmien monimutkaisuuden ymmärtämiseen ja riittävään koulutukseen. Seuraukset kytkeytyivät organisaatioihin, ammattilaisiin sekä potilaisiin ja heidän hoitoonsa. Seuraavaksi toteutettiin kuvaileva laadullinen tutkimus, joka sisälsi kaksi osatutkimusta. Aineistot kerättiin yksilöhaastatteluilla (n=21) perusterveydenhuollossa ja ryhmähaastatteluilla (n=6) erikoissairaanhoidossa toimivilta johtajilta (n=20). Aineistot analysoitiin induktiivisella ja deduktiivis-induktiivisella sisältöanalyysilla. Ensimmäisen osatutkimuksen perusteella muodostettiin kuusi pääkategoriaa, joita olivat strateginen, operatiivinen ja transformationaalinen johtajuus, oman ja työntekijöiden digitaalisen osaamisen varmistaminen, etäjohtajuus sekä yhteistyön johtajuus ja yhteiskehittäminen. Toisessa osatutkimuksessa kuvattiin johtajien piirteitä, kognitiota ja käyttäytymistä. Vaiheessa II muodostettiin hypoteettinen malli johtajuudesta digitaalisten terveyspalvelujen kontekstissa. Hypoteettisessa mallissa kuvattiin johtajuuden edeltäjiä, ominaisuuksia ja seuraamuksia digitaalisten terveyspalvelujen kontekstissa. Johtajuuden piirteet liittyivät ominaisuuksiin, rooleihin, käyttäytymiseen, affekteihin ja kognitioon. Tutkimus tuotti uutta tietoa johtajuudesta digitaalisten terveyspalvelujen kontekstissa. Hypoteettista mallia voidaan hyödyntää terveydenhuollon digitalisaation edistämisessä, johtajien koulutuksen kehittämisessä sekä terveydenhuollon johtajuuden ja digitalisaation tutkimuksessa.

The recently described biological framework of Alzheimer's disease (AD) emphasizes three types of pathology to characterize this disorder, referred to as the 'amyloid/tau/neurodegeneration' (A-T-N) status. The 'neurodegenerative' component is typically defined by atrophy measures derived from structural magnetic resonance imaging (MRI) such as hippocampal volume. Neurodegeneration measures from imaging are associated with disease symptoms and prognosis. Thus, sensitive image-based quantification of neurodegeneration in AD has an important role in a range of clinical and research operations. Although hippocampal volume is a sensitive metric of neurodegeneration, this measure is impacted by several clinical conditions other than AD and therefore lacks specificity. In contrast, selective regional cortical atrophy, known as the 'cortical signature of AD' provides greater specificity to AD pathology. Although atrophy is apparent even in the preclinical stages of the disease, it is possible that increased sensitivity to degeneration could be achieved by including tissue microstructural properties in the neurodegeneration measure. However, to facilitate clinical feasibility, such information should be obtainable from a single, short, noninvasive imaging protocol. We propose a multiscale MRI procedure that advances prior work through the quantification of features at both macrostructural (morphometry) and microstructural (tissue properties obtained from multiple layers of cortex and subcortical white matter) scales from a single structural brain image (referred to as 'multi-scale structural mapping'; MSSM). Vertex-wise partial least squares (PLS) regression was used to compress these multi-scale structural features. When contrasting patients with AD to cognitively intact matched older adults, the MSSM procedure showed substantially broader regional group differences including areas that were not statistically significant when using cortical thickness alone. Further, with multiple machine learning algorithms and ensemble procedures, we found that MSSM provides accurate detection of individuals with AD dementia (AUROC = 0.962, AUPRC = 0.976) and individuals with mild cognitive impairment (MCI) that subsequently progressed to AD dementia (AUROC = 0.908, AUPRC = 0.910). The findings demonstrate the critical advancement of neurodegeneration quantification provided through multiscale mapping. Future work will determine the sensitivity of this technique for accurately detecting individuals with earlier impairment and biomarker positivity in the absence of impairment.

Massive open online courses (MOOCs) provide accessible and engaging information for Physical Therapy and Occupational Therapy students. The objective of this research was to determine the usefulness in improving academic performance and empathy in health sciences undergraduates, and to test a hypothetical model through structural equation analysis. This research was carried out using a descriptive and quasi-experimental design. It was conducted in a sample of 381 participants: 176 used a MOOC and 205 did not. The results of the Student’s t-test showed statistically significant differences in academic performance between the groups in favor of those students who had realized the MOOC. Participants carried out an evaluation rubric after taking MOOC. Statistically significant differences in empathy were also obtained between the pre (X = 62.06; SD = 4.41) and post (X = 73.77; SD = 9.93) tests. The hypothetical model tested via structural equation modeling was supported by the results. Motivation for the MOOC explained 50% of the variance. The MOOC (participation and realization) explained 58% of academic performance, 35% of cognitive empathy and 48% of affective empathy. The results suggest an association between higher realization and participation in a MOOC and higher levels of academic performance, and cognitive and affective empathy., University of Malaga (UMA) for the Call for Educational Innovation Projects (PIE19-148), to the Call 2019-2021, Initiation Grant for Research from the UMA's Own Plan, in Modality A (Grade)

Mild cognitive impairment (MCI) is a heterogeneous condition with variable outcomes. Improving diagnosis to increase the likelihood that MCI reliably reflects prodromal Alzheimer’s Disease (AD) would be of great benefit for clinical practice and intervention trials. In 230 cognitively normal (CN) and 394 MCI individuals from the Alzheimer’s Disease Neuroimaging Initiative, we studied whether an MCI diagnostic requirement of impairment on at least two episodic memory tests improves 3-year prediction of medial temporal lobe atrophy and progression to AD. Based on external age-adjusted norms for delayed free recall on the Rey Auditory Verbal Learning Test (AVLT), MCI participants were further classified as having normal (AVLT+, above −1 SD, n = 121) or impaired (AVLT -, −1 SD or below, n = 273) AVLT performance. CN, AVLT+, and AVLT- groups differed significantly on baseline brain (hippocampus, entorhinal cortex) and cerebrospinal fluid (amyloid, tau, p-tau) biomarkers, with the AVLT- group being most abnormal. The AVLT- group had significantly more medial temporal atrophy and a substantially higher AD progression rate than the AVLT+ group (51% vs. 16%, p

Suicide prevention is an increasingly important issue, especially among older people. Recent work on improving its effectiveness has focused on developing a framework aligning interventions with key risk factors and stages of the suicide process. We have developed this further, by integrating psycho-behavioral components associated with suicide, existing guidelines for identifying critical points of intervention, and the previous preventive strategies framework. Our schematic diagram shows the relationship between the suicide process and prevention strategies, combined with initiatives for linking different types of strategies, from universal strategies at population level, through selective strategies focusing on groups at risk, to indicated strategies, aimed at specific high-risk individuals. We tested our framework using previous studies assessing the impact of suicide prevention interventions on suicide rates in older adults. It was possible to place all identified interventions within the framework. Examining effectiveness within the framework suggests that some interventions may be more successful in reducing suicide rates because they developed systematic linkages between universal, selective, and indicated prevention interventions. Other studies, however, show that interventions can be successful without these linkages, so other factors may also be important. The main weakness of our framework is a lack of evidence about critical intervention points within the suicide process, which may limit its practical application. However, the framework may help to improve the linkages between types of interventions, and support practitioners in developing a wide range of strategies across different areas and stages of the suicide process.

Over the last decade, municipal solid waste generation in Phnom Penh has increased noticeably, however, the waste management system is far from satisfactory. Considerable amount of waste is left uncollected, as well as intentionally disposed of in public open spaces. External and internal factors can trigger these problems. Possible external factors are low collection frequency, low cleaning services, and insufficient facilities such as small dumpsters. Possible internal factors, which also play an important role in this issue, include low awareness, insufficient knowledge, and low responsibility for personal waste. To examine the influences of these internal and external factors on people&rsquo, s waste disposal behaviors, we selected and conducted a questionnaire survey at four sites in Phnom Penh that differ in waste collection frequency and population density. A total of 413 valid responses were obtained. We developed a structural equation model to explain people&rsquo, s intentions not to dispose of waste in public open spaces. The results showed that personal and social norms, such as perception of social pressure from friends and family and from the government, had significant influences on intention, whereas the influence of external factors was much smaller.

Highlights • ApoE4-related changes on gray matter networks are associated with AD progression in MCI. • Gray matter topological organization predicts a steeper decline in cognitive functioning. • Network topological measures might detect progression to dementia in MCI patients., There is evidence that gray matter networks are disrupted in Mild Cognitive Impairment (MCI) and associated with cognitive impairment and faster disease progression. However, it remains unknown how these alterations are related to the presence of Apolipoprotein E isoform E4 (ApoE4), the most prominent genetic risk factor for late-onset Alzheimer’s disease (AD). To investigate this topic at the individual level, we explore the impact of ApoE4 and the disease progression on the Single-Subject Gray Matter Networks (SSGMNets) using the graph theory approach. Our data sample comprised 200 MCI patients selected from the ADNI database, classified as non-Converters and Converters (will progress into AD). Each group included 50 ApoE4-positive (‘Carriers', ApoE4 + ) and 50 ApoE4-negative ('non-Carriers', ApoE4-). The SSGMNets were estimated from structural MRIs at two-time points: baseline and conversion. We investigated whether altered network topological measures at baseline and their rate of change (RoC) between baseline and conversion time points were associated with ApoE4 and disease progression. We also explored the correlation of SSGMNets attributes with general cognition score (MMSE), memory (ADNI-MEM), and CSF-derived biomarkers of AD (Aβ42, T-tau, and P-tau). Our results showed that ApoE4 and the disease progression modulated the global topological network properties independently but not in their RoC. MCI converters showed a lower clustering index in several regions associated with neurodegeneration in AD. The SSGMNets' topological organization was revealed to be able to predict cognitive and memory measures. The findings presented here suggest that SSGMNets could indeed be used to identify MCI ApoE4 Carriers with a high risk for AD progression.

Background: Non-invasive characterization of the pathological features of Alzheimer's disease (AD) could enhance patient management and the development of therapeutic strategies. Magnetic resonance imaging texture analysis (MRTA) has been used previously to extract texture descriptors from structural clinical scans in AD to determine cerebral tissue heterogeneity. In this study, we examined the potential of MRTA to specifically identify tau pathology in an AD mouse model and compared the MRTA metrics to histological measures of tau burden. Methods: MRTA was applied to 12 weighted high-resolution MR images of nine 8.5-month-old rTg4510 tau pathology (TG) mice and 16 litter matched wild-type PT) mice. MRTA comprised of the filtration-histogram technique, where the filtration step extracted and enhanced features of different sizes (fine, medium, and coarse texture scales), followed by quantification of texture using histogram analysis (mean gray level intensity, mean intensity, entropy, uniformity, skewness, standard-deviation, and kurtosis). MRTA was applied to manually segmented regions of interest (ROl) drawn within the cortex, hippocampus, and thalamus regions and the level of tau burden was assessed in equivalent regions using histology. Results: Texture parameters were markedly different between WT and TG in the cortex (E, p < 0.01, K, p < 0.01), the hippocampus (K, p < 0.05) and in the thalamus (K, p, 0.01). In addition, we observed significant correlations between histological measurements of tau burden and kurtosis in the cortex, hippocampus and thalamus. Conclusions: MRTA successfully differentiated WT and TG in brain regions with varying degrees of tau pathology (cortex, hippocampus, and thalamus) based on T2 weighted MR images. Furthermore, the kurtosis measurement correlated with histological measures of tau burden. This initial study indicates that MRTA may have a role in the early diagnosis of AD and the assessment of tau pathology using routinely acquired structural MR images.

Background: Performance on episodic, semantic, and working memory tests is impaired in Alzheimer's disease (AD)-type dementia, but it is unclear which type of memory test is most strongly associated with early AD biomarkers in cerebrospinal fluid (CSF), and most useful for monitoring disease progression.Objective: To examine the association between amyloid-beta 1-42 (A beta(42)) and tau in CSF with performance on different memory domains at baseline, and how these CSF markers are related with memory decline.Methods: We included 263 individuals with normal cognition, mild cognitive impairment, AD-type dementia, and non-AD dementia from the European EDAR study. Assessment included CSF A beta(42) and t-tau analyses with INNO-BIA AlzBio3 Luminex assay, the CERAD wordlist learning and delayed recall, animal fluency test, and the CANTAB Paired Associates Learning (PAL) and Spatial Working Memory tasks. Follow-up assessments were performed within 3 years after baseline.Results: At baseline, decreased CSF A beta(42) correlated most strongly with the PAL total errors adjusted and the wordlist delayed recall and increased CSF t-tau with the wordlist delayed recall. Over time, decreased CSF A beta(42) was associated with decline on the wordlist learning, whereas increased CSF t-tau were associated with decline in scores on the wordlist learning, wordlist delayed recall, and animal fluency. Associations were independent of baseline diagnosis.Conclusion: Tests assessing episodic verbal and visuospatial memory are most useful for detection of AD pathology. Tests for episodic verbal memory and semantic memory are most useful for tracking memory decline.

The purpose of this study was to present a hypothetical model for improving and enhancing mental health using exercise and physical activity by investigating the mediating role of psycho-social factors, and to discuss the relationship among constructive concept of this mode1. Two-hundred thirty-four male and 81 female students participated in this study, and completed a questionnaire including Physical Activity Index (Murakami and Hashimoto, 2004), types of exercise participation (Hashimoto, 2004), and Diagnostic Inventory for Mental Health Pattern (Hashimoto and Tokunaga, 1999). In addition, Kikuch’s Social Ski11: KiSS (Kikuchi, 1998) and consciousness of others scale (Tsuji, 2001) were administered to assess psycho-social variables. Results showed that exercise and physical activity were positively related to social skill and consciousness of others, and the strength of this relationship was greater for males compared to females. Unexpectedly, exercise and physical activity did not show a relationship with mental health(stress and QOL). Moreover, there was a trend for social skill to relate positively with mental health, but there was not relationship between consciousness of others and mental health. Thus, results only partially supported the proposed model. These findings are discussed in addition to the need for investigation of other possible mediators.