The role of cognitive reserve in protecting cognitive ability in people with HIV
Notice bibliographique
Résumé
The landscape of HIV-1 disease has radically improved with the contemporary anti-retroviral therapy. However, HIV-associated neurocognitive disorders (HAND) continue to be a challenge even among those with an optimal drug regime. Although neurocognitive deficits are typically of mild nature, the burden associated with HAND is an emerging public health concern due to unrelenting repercussions on everyday functioning including medication adherence, employment, and overall survival. Could people with HIV somehow protect themselves from cognitive impairment? Cognitive reserve is a theoretical entity which has been put forward to offset the deleterious impact of brain pathology on cognitive performance. This thesis investigated the impact of cognitive reserve on cognitive performance in individuals with HIV.The thesis commenced with a systematic review and a meta-analysis of the published literature (N=10) to estimate the strength of association between cognitive reserve and cognitive performance in HIV (Manuscript I). The association between the two constructs was found to be moderately strong. This work showed that discrepant indicators have been employed to operationalize cognitive reserve in HIV. It was found that participation in leisure and social activities was infrequently employed as an indicator of cognitive reserve in these HIV studies. This review produced a framework which hypothesized the mediating role of cognitive reserve on brain pathology and its consequences from the context of rehabilitation.The second manuscript quantified cognitive reserve into a single numeric value utilizing various indicators which have been proposed to build cognitive reserve. Pertinent data (including education, occupation, social network, number of spoken languages, and participation in other cognitively stimulating activities) were acquired from a Canadian longitudinal study (N=856) with HIV+ individuals to devise an index of cognitive reserve based on the differential impact of each indicator. This work involved a standard methodology where the regression coefficients for each contributing indicator were used in the scoring algorithm. A correlation coefficient of 0.3 between the developed index and a measure of cognitive performance at follow-up was expected given its hypothesized role as a mediator of cognitive performance rather than having a direct effect. Manuscript III documented the feasibility and efficacy potential of a 12-week combined aerobic and resistance training program in improving cognitive performance in HIV (N=27). This study was a subset of a cohort multiple randomized controlled trial which provided access to the participants who were eligible for the exercise program. As expected, physical performance measures showed improvements post-training. No positive influence was observed on the primary efficacy potential outcome of cognitive performance.Lastly, a systematic review was carried out to address some questions which surfaced at the outset of the aforementioned feasibility study. For instance, are pilot and feasibility studies the same? What should be the key objectives of a pilot study? What happens to a pilot study once it is completed? Does an effect size observed in a pilot study predict its follow-up? These questions were addressed based on 191 feasibility studies published in a specific rehabilitation journal since its inception. This work demonstrated that feasibility outcomes were often disregarded in the measurement strategy of these studies. Only a minor proportion of the studies got followed-up in a full-strength clinical trial and effect size did not drive this follow-up. This manuscript generated key areas of focus relevant to feasibility studies designed in rehabilitation research.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,015 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».