Current status and future directions for the diagnosis and management of mild cognitive impairment in Southeast Asia: A SEACURE consensus paper.

Global aging populations are facing increased prevalence of mild cognitive impairment (MCI) - the preclinical stage of dementia characterized by single/multi-domain neurocognitive decline that does not impair an individual's normal daily functioning. Asian populations are at increased risk of developing MCI and dementia, and many cases go undetected in Southeast Asia (SEA), resulting in increased burden on patients, caregivers and national healthcare systems. There is an urgent need for efficient and scalable diagnostic and management strategies across SEA.

Frailty, malnutrition, healthcare utilization, and mortality in patients with dementia and cognitive impairment obtained from hospital administrative data.

Introduction: With aging populations, the prevalence of dementia, frailty and malnutrition will increase. The aim of this study is twofold (a) to determine the demographic data, including frailty and malnutrition prevalence in older patients with diagnosis of dementia and/or cognitive impairment and (b) to determine its impact on outcomes such as length of stay (LOS), readmission and mortality stratified by frailty status.

Methods: Retrospective single-center cohort study conducted using hospital database on older patients ≥65 yrs.

Trends in substance use-related emergency department visits by youth, 2018-2023.

Background: We aimed to examine trends in substance use-related emergency department (ED) visits for youth from 2018 to 2023, compare the patient characteristics, types of substance involved, and ED disposition for these visits, and calculate revisit frequency.

Methods: Retrospective review of electronic health records (EHRs) from six EDs in an urban healthcare system to identify 12-21-year-old patients with substance use-related ED visits from 2018 to 2023. Visits were identified by International Classification of Diseases, 10th Revision Clinical Modification codes for substance use.

International Consensus on Evidence Gaps and Research Opportunities in Extracorporeal Cardiopulmonary Resuscitation for Refractory Out-of-Hospital Cardiac Arrest: A Report From the National Heart, Lung, and Blood Institute Workshop.

The increased accessibility of extracorporeal membrane oxygenation following the COVID-19 pandemic and the publication of the first randomized trial of extracorporeal cardiopulmonary resuscitation (ECPR) prompted the National Heart, Lung, and Blood Institute to sponsor a workshop on ECPR. Two more randomized trials have since been published in 2022 and 2023. Based on the combined findings and review of the evidence, an international panel of authors identified gaps in science, inequities in care and diversity in outcomes, and suggested research opportunities and next steps.

Associations between residential segregation, ambient air pollution, and hippocampal features in recent trauma survivors.

Background: Residential segregation is associated with differential exposure to air pollution. Hippocampus structure and function are highly susceptible to pollutants and associated with posttraumatic stress disorder (PTSD) development. Therefore, we investigated associations between residential segregation, air pollutants, hippocampal neurobiology, and PTSD in recent trauma survivors.

Adaptation and validation of a Rwanda-focused version of the Alcohol Use Disorder Identification Test (AUDIT).

In Rwanda, alcohol use disorder (AUD) is estimated to affect 7% of the population. The Alcohol Use Disorder Identification Test (AUDIT) is an excellent screening instrument for AUD, but a Rwanda-focused version previously was unavailable. Our objective was to develop a Rwanda- focused AUDIT and evaluate its psychometric properties.

A co-designed conceptual model for implementing falls prevention programmes for community-dwelling older adults in Singapore: a systems thinking approach.

Introduction: Implementing falls prevention programmes in the community presents numerous challenges. We sought to understand the dynamics between the determinants influencing implementation to develop a common conceptual model describing the complexities of implementing falls prevention programmes in Singapore.

Methods: A full-day group model building workshop with a series of structured activities was organised with 31 multidisciplinary stakeholders.

Sarcopenia, sarcopenic obesity, and frailty in individuals with chronic kidney disease: a comprehensive review.

Population aging is a global challenge that increases the burden of chronic kidney disease (CKD) and geriatric syndromes such as sarcopenia, sarcopenic obesity, and frailty. These conditions affect almost half of older CKD individuals and are associated with poor outcomes, including CKD progression, cardiometabolic complications, increased health and social care costs, and mortality. They can be both the cause and consequent of CKD and lead to a vicious downward spiral if not addressed early.

Heterocyclic Assembly: An Underutilized Disconnection with Potential to Maximize High Fsp Chemical Space Exploration.

From a retrosynthetic standpoint, or heterocyclic cores are fundamental disconnections that chemists make. This manuscript highlights heterocycle synthesis as the strategic bond disconnection by leveraging ubiquitous building blocks, carboxylic acids and amines, for preparation of heterocyclic cores in a library-friendly format. This heterocyclic formation strategy allows medicinal chemists to access much wider chemical space, especially for analogs with higher Fsp vs state-of-the-art heterocycle functionalization methods.

Developing a Delphi consensus on the domains and conduct of brief geriatric assessments in Singapore.

Background: Comprehensive geriatric assessment (CGA) is a process supporting a multidimensional assessment of the health and well-being of older adults and leads to the development of long-term personalized care plans. CGA is resource intensive, hence shorter forms such as brief geriatric assessments (BGA) could be alternatives. However, little is known about BGA's implementability in community and primary care settings.

The Healthcare Subsidy Assessment Survey: A Novel and Validated Poverty Assessment Tool to Inform Medical Cost Subsidization in Rural Uganda.

Background: Approximately 30% of the global burden of disease is surgical, but two-thirds of the world's population cannot access safe, affordable, and timely surgical care. An ambulatory surgical center (ASC) in Uganda offers subsidized and free care to some patients, but identifying patients in greatest need is challenging. We aimed to develop an unbiased tool appropriate for medical settings to determine subsidy eligibility to prevent catastrophic healthcare expenditure (CHE) for ASC's patients.

Colorectal Cancer and Quality of Life: A Medicare Advantage Study by Race, Ethnicity, and Language.

Background And Methods: Colorectal cancer (CRC) treatment can influence health-related quality of life (HRQOL). This study examined HRQOL among older adults undergoing CRC treatment, and the conditional effects of race, ethnicity, and primary language. We conducted a retrospective cohort study of Medicare Advantage enrollees ≥ 65 years old who completed the Medicare Health Outcomes Survey (MHOS) (2016-2020).

Optimising dementia screening in community-dwelling older adults: A rapid review of brief diagnostic tools in Singapore.

Introduction: Timely detection of dementia enables early access to dementia-specific care services and interventions. Various stakeholders brought together to refine Singapore's dementia care strategy identified a lack of a standardised cognitive screening tool and the absence of a comparative review of existing tools. We hence conducted a rapid review to evaluate the diagnostic performance of brief cognitive screening tools in identifying possible dementia among community-dwelling older adults in Singapore.

An expert consensus statement on biomarkers of ageing for use in intervention studies.

Biomarkers of ageing serve as important outcome measures in longevity-promoting interventions. However, there is limited consensus on which specific biomarkers are most appropriate for human intervention studies. This work aimed to address this need by establishing an expert consensus on biomarkers of ageing for use in intervention studies via the Delphi method.

Integrating Patient-Generated Digital Data Into Mental Health Therapy: Mixed Methods Analysis of User Experience.

Background: Therapists and their patients increasingly discuss digital data from social media, smartphone sensors, and other online engagements within the context of psychotherapy.

Objective: We examined patients' and mental health therapists' experiences and perceptions following a randomized controlled trial in which they both received regular summaries of patients' digital data (eg, dashboard) to review and discuss in session. The dashboard included data that patients consented to share from their social media posts, phone usage, and online searches.

Peritraumatic C-reactive protein levels predict pain outcomes following traumatic stress exposure in a sex-dependent manner.

Background: Chronic pain following traumatic stress exposure (TSE) is common. Increasing evidence suggests inflammatory/immune mechanisms are induced by TSE, play a key role in the recovery process versus development of post-TSE chronic pain, and are sex specific. In this study, we tested the hypothesis that the inflammatory marker C-reactive protein (CRP) is associated with chronic pain after TSE in a sex-specific manner.

Disparities by Race and Urbanicity in Online Health Care Facility Reviews.

Importance: Online review platforms offer valuable insights into patient satisfaction and the quality of health care services, capturing content and trends that traditional metrics might miss. The COVID-19 pandemic has disrupted health care services, influencing patient experiences.

Objective: To examine health care facility numerical ratings and patient experience reported on an online platform by facility type and area demographic characteristics after the COVID-19 pandemic (ie, post-COVID).