: This study is a parallel-arm randomized controlled trial evaluating choral singing's efficacy and underlying mechanisms in preventing cognitive decline in at-risk older participants.
: ...Three-hundred and sixty community-dwelling, non-demented older participants are recruited for a 2-year intervention. Inclusion criteria are self-reported cognitive complaints, early cognitive impairment based on neuropsychological test scores or multiple risk factors of dementia. Participants are randomized to either weekly choral singing sessions or general health education. The primary outcome is cognitive performance, measured by a composite cognitive test score (CCTS). Secondary outcomes include depression, anxiety and neuropsychiatric symptoms; perceived stress; sleep quality and severity of dementia symptoms. Underlying mechanisms are examined using blood- and urine-based biomarkers and neuroimaging.
: Screening began in July 2016. The first group of participants (
= 93) have been recruited. Intervention and control treatments are ongoing and will end in December 2019.
: An evidence-based singing intervention for dementia prevention holds potential for healthcare savings and societal welfare.
: NCT02919748, IRB Approval Number: NUS 2508.
We conducted a randomized controlled trial to examine choral singing's effect on cognitive decline in aging. Older Singaporeans who were at high risk of future dementia were recruited: 47 were ...assigned to choral singing intervention (CSI) and 46 were assigned to health education program (HEP). Participants attended weekly one-hour choral singing or weekly one-hour health education for two years. Change in cognitive function was measured by a composite cognitive test score (CCTS) derived from raw scores of neuropsychological tests; biomarkers included brain magnetic resonance imaging, oxidative damage and immunosenescence. The average age of the participants were 70 years and 73/93 (78.5%) were female. The change of CCTS from baseline to 24 months was 0.05 among participants in the CSI group and -0.1 among participants in the HEP group. The between-group difference (0.15,
=0.042) became smaller (0.12,
=0.09) after adjusting for baseline CCTS. No between-group differences on biomarkers were observed. Our data support the role of choral singing in improving cognitive health in aging. The beneficial effect is at least comparable than that of health education in preventing cognitive decline in a community of elderly people. Biological mechanisms underlying the observed efficacy should be further studied.
This study contributes new empirical evidence on the profitability of a momentum strategy in the Philippines equity market. The study was conducted over the time period January 2000 to June 2012. We ...evaluated a momentum strategy based only on past return information as well as a strategy that incorporates information on volume for 16 different time combinations with varying formation and holding periods. For the strategy based only on past return information, we find little evidence in support of the profitability of a momentum strategy with the results suggesting the presence of mean-reverting prices. When volume information is incorporated, the strategies that select stocks based on volume and return information from the past 3 months show positive average monthly returns. However, after adjusting for the risk of these strategies using a single factor model and a model with market-dependent betas we find that such a strategy does not outperform the benchmark. Hence, we conclude that there is little evidence to support the profitability of a volume-augmented momentum strategy in the Philippines equity market. PUBLICATION ABSTRACT
•There was a substantial shift in the population at risk of COVID-19 in Singapore over time.•Successful control in the community protected an at-risk aging population.•There were large outbreaks in ...the younger migrant worker population, with less severe disease.•This resulted in one of the lowest case fatality rates globally.
The vast majority of COVID-19 cases in Singapore have occurred amongst migrant workers. This paper examined trends in the hospitalised cases and tested the assumption that the low severity of disease was related to the relatively young affected population.
All patients with PCR-positive SARS-CoV-2 admitted from February to April 2020 were divided into: (i) imported cases, (ii) locally-transmitted cases outside migrant worker dormitories and (iii) migrant worker dormitory cases. They were examined for underlying comorbidities, clinical progress and outcomes.
Imported cases (n = 29) peaked in mid-March 2020, followed by local cases (n = 100) in mid-April 2020; migrant worker cases (n = 425) continued to increase in late April 2020. Migrant worker cases were younger, had few medical comorbidities and less severe disease. As the migrant worker cases increased, the proportion of patients with pneumonia decreased, whilst patients presenting earlier in their illness and asymptomatic disease became more common.
Singapore experienced a substantial shift in the population at risk of severe COVID-19. Successful control in the community protected an aging population. Large migrant worker dormitory outbreaks occurred, but the disease incurred was less severe, resulting in Singapore having one of the lowest case fatality rates in the world.
Abstract
Background
A socioculturally appropriate appreciation of dignity is pivotal to the effective provision of care for dying patients. Yet concepts of dignity remain poorly defined. To address ...this gap in understanding and enhance dignity conserving end-of-life care, a review of current concepts of dignity is proposed.
Methods
To address its primary research question “How do patients conceive the concept of dignity at the end of life?”, this review appraises regnant concepts and influences of dignity, and evaluates current dignity conserving practices. To enhance accountability, transparency and reproducibility, this review employs the Ring Theory of Personhood (RToP) as its theoretical lens to guide a Systematic Evidence Based Approach guided Systematic Scoping Review (SSR in SEBA) of patient perspectives of dignity. Three independent teams of reviewers independently analysed included articles from a structured search of PubMed, Embase, PsycINFO, Scopus, CINAHL and Cochrane Databases using thematic and content analyses. The themes and categories identified were compared and combined using the Funnelling Process to create domains that guide the discussion that follows.
Results
Seventy-eight thousand five hundred seventy-five abstracts were identified, 645 articles were reviewed, and 127 articles were included. The three domains identified were definitions of dignity, influences upon perceptions of dignity, and dignity conserving care.
Conclusions
This SSR in SEBA affirms the notion that dignity is intimately entwined with self-concepts of personhood and that effective dignity conserving measures at the end of life must be guided by the patient’s concept of dignity. This SSR in SEBA posits that such personalised culturally sensitive, and timely support of patients, their family and loved ones may be possible through the early and longitudinal application of a RToP based tool.
For a small satellite, the processor onboard the attitude determination and control system (ADCS) is required to monitor, communicate, and control all the sensors and actuators. In addition, the ...processor is required to consistently communicate with the satellite bus. Consequently, the processor is unable to ensure all the sensors and actuators will immediately respond to the data acquisition request, which leads to asynchronous data problems. The extended Kalman filter (EKF) is commonly used in the attitude determination process, but it assumes fully synchronous data. The asynchronous data problem would greatly degrade the attitude determination accuracy by EKF. To minimize the attitude estimation accuracy loss due to asynchronous data while ensuring a reasonable computational complexity for small satellite applications, this paper proposes the simplex-back-propagation Kalman filter (SBPKF). The proposed SBPKF incorporates the time delay, gyro instability, and navigation error into both the measurement and covariance estimation during the Kalman update process. The performance of SBPKF has been compared with EKF, modified adaptive EKF (MAEKF), and moving–covariance Kalman filter (MC-KF). Simulation results show that the attitude estimation error of SBPKF is at least 30% better than EKF and MC-KF. In addition, the SBPKF’s computational complexity is 17% lower than MAEKF and 29% lower than MC-KF.
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