Prevalence and prognosis of PIK3CA mutations in Bulgarian patients with metastatic breast cancer receiving endocrine therapy in first-line setting

BACKGROUND AND AIMS

In approximately 40% of patients with HER2-negative/HR-positive breast cancer tumors, the PIK3CA gene is mutated. Despite this, clinical outcomes vary between studies in this cohort. We aimed to ascertain the prevalence of PIK3CA mutations in patients with metastatic HR+/HER2- breast in Bulgaria, as well the evaluation and comparison of progression free survival (PFS) between wild-type (WT) and mutation-positive groups in the real-world setting.

METHODS

Three oncology centers in Bulgaria collected 250 tissue samples between 2016 and 2022 for this multicentric retrospective study. PIK3CA mutations were identified using Real-Time qPCR. The median follow-up period was 35 months.

RESULTS

The mean age of the mutant cohort was 57.6 ± 11.6 years, compared to 56.5 ± 12.2 years for the WT cohort (p = .52). The percentage of patients with visceral metastasis was 58.8% (n = 147). Approximately 84.3% (n = 210) of the patients had reached postmenopause. 29.2% (n = 73) of the patients had PIK3CA mutations. The predominant mutation was present in exon 20, H1047R (46.5%). We found a significant correlation only between the presence of a mutation and the metastatic diseases at diagnosis (p = .002). As first-line therapy, 67.1% of patients received endocrine therapy (ET) plus cyclin dependent kinase (CDK4/6) inhibitor, while the remainder received ET alone. The median PFS of patients in the group with the mutation was 32 months (95%, CI: 22-40) compared to 24 months in the WT cohort ((95%, CI: 21-36) (p = .45)); HR = 0.86 (95%, CI: 0.5-1.3) (p = .46). We corroborated our conclusion using propensity matching score analysis, (36 months [95% CI: 20-40] vs. 26 months [95% CI: 21-38], [p = .69]).

CONCLUSIONS

We found that the prevalence of PIK3CA mutations in our patients was comparable to what has been reported in other nations. Our results suggest that PIK3CA mutational status has no bearing to ET efficacy in first-line setting.

Safety evaluation of the use of one- and two-component fungicides to protect grapes

Viticulture and winemaking are traditional industry of agriculture in the southern regions of the Russian Federation, which playing an important role in their economy. A rich and undamaged crop is almost impossible to grow without plant protection measures. Preparations used to spray plants are by no means harmless, and do not always completely disintegrate before harvesting. The objective of the work was to study the dynamics of degradation of fungicides of systemic action, belonging to different classes, in grapes. The two-component preparation was a combination of 120 g/l difenoconazole + 60 g/l tetraconazole (MEC). The one-component preparation contained 250 g/l of cyprodinil (EC). The work was done in the Krasnodar region for 2 years. The half-lives of difenoconazole and tetraconazole were about 5 days, cyprodinil 2.7 and 4 days, 1 and 2 years, respectively. The concentration of difenoconazole and tetraconazole went down to below the MRL in the first year of the study, two weeks after the last spraying, and in the second – after three weeks, which was most likely caused by the prevailing weather conditions – “dangerous phenomenon – intense heat”. At the time of harvest, no residual amounts of difenoconazole, tetraconazole and cyprodinil were found, which indicates the safety of the products obtained for consumers.

The Beat Goes On: Stimulant Use and HIV in the Era of COVID-19

Background

Evidence suggests that economic, social, and psychological circumstances brought about by the COVID-19 pandemic may have a serious impact on behavioral health. Men who have sex with men (MSM) are disproportionally impacted by HIV and stimulant use, the co-occurrence of which heightens HIV transmission risk and undermines nationwide treatment strategies as prevention efforts for ending the HIV epidemic. There is a paucity of information regarding the potential impact of the COVID-19 pandemic on the substance use and HIV medication adherence in this key vulnerable population—MSM who use stimulants and are living with HIV.

Objective

The aim of this qualitative study was to identify ways in which the COVID-19 pandemic has affected stimulant use and antiretroviral therapy (ART) adherence among a sample of MSM living with HIV.

Methods

Two focus groups were conducted in August 2020 via videoconferencing technology compliant with the Health Insurance Portability and Accountability Act. Potential participants from an established research participant registry at State University of New York Downstate Health Sciences University were invited and screened for study participation on the basis of inclusion criteria. A semistructured interview guide was followed. A general inductive approach was used to analyze the data. Findings in two general areas of interest, the impact of the COVID-19 pandemic on stimulant use and ART adherence, emerged directly from the raw data.

Results

A total of 12 ethnically diverse participants over the age of 25 years took part in the study. Results were heterogeneous in terms of the effects of the pandemic on both stimulant use and ART adherence among MSM living with HIV. Some men indicated increased or sustained stimulant use and ART adherence, and others reported decreased stimulant use and ART adherence. Reasons for these behavioral changes ranged from concerns about their own health and that of their loved ones to challenges brought about by the lack of daily structure during the lockdown phase of the pandemic and emotion regulation difficulties.

Conclusions

The COVID-19 pandemic has had a differential impact on stimulant use and ART medication adherence among MSM living with HIV. The reasons for behavioral change identified in this study may be salient intervention targets to support ART medication adherence and lower stimulant use among MSM in the aftermath of the of the COVID-19 pandemic, as well as beyond.

AB0636 ASYMPTOMATIC HYPERURICEMIA IN INFLAMMATORY RHEUMATIC DISEASES

Background:

Uric acid (UA) is well-known biomarker of cardiovascular risk and inflammation. However, the data about interrelations between asymptomatic hyperuricemia (AHU) and rheumatic diseases (RD) are limited and contradictory [1].

Objectives:

to identify the occurrence of AHU in pts with different RD and to evaluate the interrelations between the AHU and clinical features of the RD.

Methods:

The study included data from 822 pts with AHU and RD involved in the Saint-Petersburg Register of Pts with AHU in period from the 01jan2000 to the 01apr2020. The AHU was defined as the serum level of uric acid (UA) that exceeded 360 μmol/l without signs of gouty arthritis. Pts with the secondary reasons of AHU (an oncologic diseases, late stages of chronic kidney disease, ets), and inflammatory diseases another than RD were excluded from the study.

Patient’s demographical characteristics, duration of AHU, level of UA, activity of RD, ESR, CRP, urate-lowering therapy (ULT) were analyzed. The study was approved by local ethic committee. Statistics was performed with SPSS17.

Results:

Characteristics of the Patients with the RD and AHU are present in Table 1. The duration of AHU in pts with the RD was 3.4±3.4 [0.08-18] years, mean duration of follow-up 2.7±4.0 years, mean number of visits during the period of follow-up was 3,2 [min 1; max 7], ESR 26.0±14.1 mm / h, CRP 19.6±21.0 mg/l.

Table 1.

Characteristics of the Patients with the Rheumatic diseases and asymptomatic hyperuricemia.

Age, years(Mean±SD)Male, %**Serum UA, μmol/l(Mean±SD)Normalization of UA during the follow-up, n (%)RD, n=82256.7±14.540.27493.3±98.5242 (29.44) ##RA, n=32964.2±12.13.74504.8±107.5#99 (30.09) ##PsA, n= 14956.6±12.953.69531.5±94.9#32 (21.48) ##SpA, n= 10745.6±15.1*33.43520.8±86.5#18 (16.82)##SLE, n=13750.3±14.1*20.44451.6±91.457 (41.61)SSc, n= 5761.0±12.422.81456.2±99.520 (35.09)SD, n= 4362.0±10.716.28442.4±107.516 (37.21)

RD – rheumatic disease; RA –– rheumatoid arthritis; PsA –– psoriatic arthritis; SpA –– spondyloarthritis; SLE –– systemic lupus erythematosus; SSc –– systemic sclerosis; SD –– Sjogren’s disease; * –– p<0.001 for the differences with RD, RA, PsA, SSc, SD; ** –– p < 0.01 for all intergroup differences; # –– p < 0.01 for the differences with RD, RA, SSc, SD; ##–– p < 0.01 for the differences with RA, SSc, SD.

Were revealed the interrelations between the level of UA and ESR (Spearmen’s R=0.1, p=0.01), and UA and CRP (Spearmen’s R =0.12, p=0.001).

The level of UA in male pts was 507.0 [361-940], in female pts 450.0 [361-1010] μmol /l (p<0.0001), in SLE pts with elevated anti-nuclear factor (ANF) UA was 429 [361-940] and with normal 494 [361-973] (p<0.0001). In pts with high and low RD activity UA was 490 [361-940] and 454 [363-1010]) μmol /l respectively, (p<0.0001). The higher UA level was found in any RD as compared with UA in low activity of the same RD (p<0.0001 for all the differences).

Normalization of UA was found in 243 (29.6 %) pts, lack of normalization of UA in 434 (52.8 %) of cases, n = 677, Table 1. ULT received 219 (26.6 %) pts. Normalization of UA without ULT was registered in 16 (1.9 %) of the pts.

Conclusion:

UA level is higher and normalize less often in patients with SpA and PsA as compered with RA, SLA, SSc and SD pts. In any of analyzed rheumatic diseases the level of UA is higher in male pts and in pts with high disease activity.

References:

[1]K.Bosmansky, M. Ondrasik. Ter Arkh.1987;59(4):22-5.

Disclosure of Interests:

None declared.

Lactobacillus rhamnosus probiotic prevents airway function deterioration and promotes gut microbiome resilience in a murine asthma model

Allergic asthma is a highly prevalent inflammatory disease of the lower airways, clinically characterized by airway hyperreactivity and deterioration of airway function. Immunomodulatory probiotic bacteria are increasingly being explored to prevent asthma development, alone or in combination with other treatments. In this study, wild-type and recombinant probiotic Lactobacillus rhamnosus GR-1 were tested as preventive treatment of experimental allergic asthma in mice. Recombinant L. rhamnosus GR-1 was designed to produce the major birch pollen allergen Bet v 1, to promote allergen-specific immunomodulation. Administration of wild-type and recombinant L. rhamnosus GR-1 prevented the development of airway hyperreactivity. Recombinant L. rhamnosus GR-1 also prevented elevation of airway total cell counts, lymphocyte counts and lung IL-1β levels, while wild-type L. rhamnosus GR-1 inhibited airway eosinophilia. Of note, a shift in gut microbiome composition was observed after asthma development, which correlated with the severity of airway inflammation and airway hyperreactivity. In the groups that received L. rhamnosus GR-1, this asthma-associated shift in gut microbiome composition was not observed, indicating microbiome-modulating effects of this probiotic. These data demonstrate that L. rhamnosus GR-1 can prevent airway function deterioration in allergic asthma. Bet v 1 expression by L. rhamnosus GR-1 further contributed to lower airway inflammation, although not solely through the expected reduction in T helper 2-associated responses, suggesting involvement of additional mechanisms. The beneficial effects of L. rhamnosus GR-1 correlate with increased gut microbiome resilience, which in turn is linked to protection of airway function, and thus further adds support to the existence of a gut-lung axis.

Effect of the Wingman-Connect Upstream Suicide Prevention Program for Air Force Personnel in Training: A Cluster Randomized Clinical Trial

IMPORTANCE

Suicide has been a leading manner of death for US Air Force personnel in recent years. Universal prevention programs that reduce suicidal thoughts and behaviors in military populations have not been identified.

OBJECTIVES

To determine whether the Wingman-Connect program for Airmen-in-training reduces suicidal ideation, depression, and occupational problems compared with a stress management program and to test the underlying network health model positing that cohesive, healthy units are protective against suicidal ideation.

DESIGN, SETTING, AND PARTICIPANTS

This cluster randomized clinical trial was conducted from October 2017 to October 2019 and compared classes of personnel followed up for 6 months. The setting was a US Air Force technical training school, with participants studied to their first base assignment, whether US or international. Participants in 216 classes were randomized, with an 84% retention rate. Data analysis was performed from November 2019 to May 2020.

INTERVENTIONS

The Wingman-Connect program used group skill building for cohesion, shared purpose, and managing career and personal stressors (3 blocks of 2 hours each). Stress management training covered cognitive and behavioral strategies (2 hours). Both conditions had a 1-hour booster session, plus text messages.

MAIN OUTCOMES AND MEASURES

The primary outcomes were scores on the suicidal ideation and depression scales of the Computerized Adaptive Test for Mental Health and self-reports of military occupational impairment. Class network protective factors hypothesized to mediate the effect of Wingman-Connect were assessed with 4 measures: cohesion assessed perceptions that classmates cooperate, work well together, and support each other; morale was measured with a single item used in other studies with military samples; healthy class norms assessed perceptions of behaviors supported by classmates; and bonds to classmates were assessed by asking each participant to name classmates whom they respect and would choose to spend time with.

RESULTS

A total of 215 classes including 1485 individuals (1222 men [82.3%]; mean [SD] age, 20.9 [3.1] years) participated; 748 individuals were enrolled in the Wingman-Connect program and 737 individuals were enrolled in the stress management program. At 1 month, the Wingman-Connect group reported lower suicidal ideation severity (effect size [ES], -0.23; 95% CI, -0.39 to -0.09; P = .001) and depression symptoms (ES, -0.24; 95% CI, -0.41 to -0.08; P = .002) and fewer occupational problems (ES, -0.14; 95% CI, -0.31 to -0.02; P = .02). At 6 months, the Wingman-Connect group reported lower depression symptoms (ES, -0.16; 95% CI, -0.34 to -0.02; P = .03), whereas the difference in suicidal ideation severity was not significant (ES, -0.13; 95% CI, -0.29 to 0.01; P = .06). The number needed to treat to produce 1 fewer participant with elevated depression at either follow-up point was 21. The benefits of the training on occupational problems did not extend past 1 month. The Wingman-Connect program strengthened cohesive, healthy class units, which helped reduce suicidal ideation severity (estimate, -0.035; 95% CI, -0.07 to -0.01; P = .02) and depression symptom scores (estimate, -0.039; 95% CI, -0.07 to -0.01; P = .02) at 1 month.

CONCLUSIONS AND RELEVANCE

Wingman-Connect is the first universal prevention program to reduce suicidal ideation and depression symptoms in a general Air Force population. Group training that builds cohesive, healthy military units is promising for upstream suicide prevention and may be essential for ecological validity. Extension of the program to the operational Air Force is recommended for maintaining continuity and testing the prevention impact on suicidal behavior.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04067401.

Drug usage analysis in pregnant women

BACKGROUND

Drug usage in pregnant women is associated with a problem of possible negative influence on prenatal development. It is always necessary to judge the need for drug administration during pregnancy.

OBJECTIVE

The aim of presented study was to analyse data about pregnant women hospitalized in the postpartum period.

METHODS

The study was designed as a retrospective observational study including 300 women hospitalized at the 2nd Department of Gynaecology and Obstetrics, University Hospital, Bratislava. Data were obtained through questionnaires in form of an interview.

RESULTS

The average age of women was 30.79 ± 4.40 years. Risk pregnancy occured in 20.59 % of women. Chronic disorders before pregnancy required regular pharmacotherapy in 29.24 %. Drug usage analysis: I. trimester, 31 % used at least one drug, 52 % nutritional supplements, 63.3 % drug and/or nutritional supplement; II. trimester, 23 % used at least one drug, 45 % nutritional supplements, 58.3 % drug and/or nutritional supplement; III. trimester, 32 % used at least one drug, 67 % nutritional supplements, 75.3 % drug and/or nutritional supplement.

CONCLUSION

Drug usage during pregnancy requires great precaution at choosing pharmacotherapy. The benefit of pharmacotherapy should always outweight the potential risk of administered drug (Tab. 3, Fig. 3, Ref. 37).

Fumigant effect of essential oils on mortality and fertility of thrips Frankliniella occidentalis Perg

The western flower thrips (Frankliniella occidentalis Perg.) is one of the most economically important insect pests of greenhouse plants. Plant protection against this pest is based predominantly on synthetic insecticides; however, this form of protection poses problems in terms of thrip resistance to the active substances, along with health risks associated with insecticide residues on the treated plants. Therefore, new active substances need to be sought. Essential oils could be a new, appropriate, and safe alternative for greenhouse culture protection. As greenhouses are enclosed areas, fumigation application of EOs is possible. This paper presents acute toxicity results for 15 commercial EOs applied by fumigation, as well as the effect of sublethal concentrations on fertility of F. occidentalis females. The most efficient EOs were obtained from Mentha pulegium and Thymus mastichina, with LC₅₀₍₉₀₎ estimated as 3.1(3.8) and 3.6 (4.6) mg L^-1 air, respectively. As found for the very first time, sublethal concentrations of EOs could result in a significant reduction in the fertility of surviving T. occidentalis females. Among the tested EOs, the EO from Nepeta cataria provided the highest inhibition of fertility, with EC₅₀₍₉₀₎ estimated as 0.18 (0.36) mg L^-1 air. Chemical composition of the most efficient EOs and possible applications of the results in practice are discussed. In conclusion, in light of the newly determined facts, EOs can be recommended as active substances for botanical insecticides to be applied against Thysanopteran pests by fumigation.

The ESC ACCA EAPCI EORP acute coronary syndrome ST-elevation myocardial infarction registry

Aims 

The Acute Cardiac Care Association (ACCA)–European Association of Percutaneous Coronary Intervention (EAPCI) Registry on ST-elevation myocardial infarction (STEMI) of the EurObservational programme (EORP) of the European Society of Cardiology (ESC) registry aimed to determine the current state of the use of reperfusion therapy in ESC member and ESC affiliated countries and the adherence to ESC STEMI guidelines in patients with STEMI.

Methods and results 

Between 1 January 2015 and 31 March 2018, a total of 11 462 patients admitted with an initial diagnosis of STEMI according to the 2012 ESC STEMI guidelines were enrolled. Individual patient data were collected across 196 centres and 29 countries. Among the centres, there were 136 percutaneous coronary intervention centres and 91 with cardiac surgery on-site. The majority of centres (129/196) were part of a STEMI network. The main objective of this study was to describe the demographic, clinical, and angiographic characteristics of patients with STEMI. Other objectives include to assess management patterns and in particular the current use of reperfusion therapies and to evaluate how recommendations of most recent STEMI European guidelines regarding reperfusion therapies and adjunctive pharmacological and non-pharmacological treatments are adopted in clinical practice and how their application can impact on patients’ outcomes. Patients will be followed for 1 year after admission.

Conclusion 

The ESC ACCA-EAPCI EORP ACS STEMI registry is an international registry of care and outcomes of patients hospitalized with STEMI. It will provide insights into the contemporary patient profile, management patterns, and 1-year outcome of patients with STEMI.

Mind the Gap: Bridging the Divide Between Current Binge Drinking Prevention and the Needs of Hispanic Underage Emerging Adults

In this article, we highlight the urgent public health need for prevention of heavy episodic drinking among underage Hispanic emerging adults in the USA. We outline the current state of binge drinking prevention programming and contrast it with the unique cultural, social, and developmental realities of this population using an ecodevelopmental framework (Szapocznik and Coatsworth 1999). Finally, we advance specific recommendations for the development and delivery of culturally tailored, multisystemic binge drinking prevention programs for underage Hispanic emerging adults.

Framework for Supporting Adolescent Peer Leaders: A Pilot Using Text Messaging in a School-Based Substance Use Prevention Program

Training peer leaders (PLs) as implementation agents is a state-of-the-art approach in prevention, but the field lacks frameworks for providing support. Text messaging, a powerful tool for direct intervention, may be useful in this regard. We introduce a conceptual framework for engaging, retaining, and educating adolescent PLs and conduct a pilot test of this framework using text messages for delivery to middle school PLs in a new, peer-led substance use prevention program. Fifty eighth-graders were recruited as PLs. We used a newly-developed framework to create text messages to strengthen peer leaders': (a) mission, agency, and team identity; (b) connection to adult mentors; (c) content knowledge and application to their own lives; and (d) preparation for prevention activities. Thirty-four texts were sent to PLs over 4 months. PL replies and participation were recorded to track engagement. Forty-one PLs (71%) received texts and completed baseline and post-program surveys. Parents and school staff completed post-program questionnaires. Eighty-five percent of PLs responded to at least one text message. Response rates for specific messages varied from 22 to 56%. Students were most likely to reply to texts about preparation for their own prevention activities in the school. Ninety-five percent of PLs said they read messages even when they did not reply. Eighty-three percent of PLs said the messages helped them accomplish their mission. PLs reported that they wanted to receive messages in the future. PL attendance had very little variability in two of the three schools, but replies to texts were associated with better attendance in one school. Our study provides a framework for supporting adolescent peer leaders in a network intervention. Automated text messaging supporting middle school PLs was feasible, engaging, and well-received. Texting activity was associated with participation in school-based activities. Future priorities include systematically varying text support to determine its true effect on implementation and on involvement by less engaged PLs.

Predictors of Participant Attendance Patterns in a Family-Based Intervention for Overweight and Obese Hispanic Adolescents

This study examined participant attendance patterns and individual (e.g., income), family dynamics (e.g., communication), and cultural (i.e., Americanism, Hispanicism) predictors of these patterns among Hispanic families enrolled in a 12-week family-based intervention, Familias Unidas for Health and Wellness. Hispanic adolescents (n = 140, 49% female, 13.04 ± 0.87 years old, 36% overweight, 64% obese, 39% immigrants) and their parents (87% female, 42.09 ± 6.30 years old, BMI 30.99 ± 6.14 kg/m², 90% immigrants) were randomized to the intervention condition. A repeated measures latent class analysis that included 12 binary variables (yes/no) of attendance identified three subgroups of attendance patterns: consistently high, moderate and decreasing, and consistently low. An ANOVA was then conducted to examine whether the identified attendance patterns differed by individual, family dynamics, and cultural characteristics at baseline. Parents in the consistently high attendance group had lower Americanism than those in either of the other attendance groups. Adolescents in the consistently high attendance group had lower Hispanicism than those in either of the other attendance groups. No other variables significantly discriminated between attendance groups. Sustained attendance in the Familias Unidas for Health and Wellness intervention may be driven by Hispanic parents' desire to better understand their host culture, connect with other culturally similar parents, and reconnect adolescents with their heritage culture.

Correction to 'Intramolecular hydrogen bonds in 1,4-dihydropyridine derivatives'

[This corrects the article DOI: 10.1098/rsos.180088.].

Intramolecular hydrogen bonds in 1,4-dihydropyridine derivatives

1,4-Dihydropyridine (1,4-DHP) derivatives have been synthesized and characterized by 1H, 13C, 15N nuclear magnetic resonance (NMR) spectroscopy, secondary proton/deuterium 13C isotope shifts, variable temperature 1H NMR experiments and quantum-chemical calculation. The intramolecular hydrogen bonds NH⋯O=C and CH⋯O=C in these compounds were established by NMR and quantum-chemical studies The downfield shift of the NH proton, accompanied by the upfield shift of the 15N nuclear magnetic resonance signals, the shift to the higher wavenumbers of the NH stretching vibration in the infrared spectra and the increase of the 1J(15N,1H) values may indicate the shortening of the N-H bond length upon intramolecular NH⋯O=C hydrogen bond formation.

Professional burnout in European young oncologists: results of the European Society for Medical Oncology (ESMO) Young Oncologists Committee Burnout Survey

Background

Burnout in health care professionals could have serious negative consequences on quality of patient care, professional satisfaction and personal life. Our aim was to investigate the burnout prevalence, work and lifestyle factors potentially affecting burnout amongst European oncologists ≤40 (YOs).

Methods

A survey was conducted using the validated Maslach Burnout Inventory (MBI) and additional questions exploring work/lifestyle factors. Statistical analyses were carried out to identify factors associated with burnout.

Results

Total of 737 surveys (all ages) were collected from 41 European countries. Countries were divided into six regions. Results from 595 (81%) YOs were included (81% medical oncologists; 52% trainees, 62% women). Seventy-one percent of YOs showed evidence of burnout (burnout subdomains: depersonalization 50%; emotional exhaustion 45; low accomplishment 35%). Twenty-two percent requested support for burnout during training and 74% reported no hospital access to support services. Burnout rates were significantly different across Europe (P < 0.0001). Burnout was highest in central European (84%) and lowest in Northern Europe (52%). Depersonalization scores were higher in men compared with women (60% versus 45% P = 0.0001) and low accomplishment was highest in the 26-30 age group (P < 0.01). In multivariable linear regression analyses, European region, work/life balance, access to support services, living alone and inadequate vacation time remained independent burnout factors (P < 0.05).

Conclusions

This is the largest burnout survey in European Young Oncologists. Burnout is common amongst YOs and rates vary across Europe. Achieving a good work/life balance, access to support services and adequate vacation time may reduce burnout levels. Raising awareness, support and interventional research are needed.

Study of interactions of mononucleotides with 1,4-dihydropyridine vesicles using NMR and ITC techniques

The possible binding site of mononucleotides is the phosphate group with important hydrophobic interactions between the mononucleotides and the alkyl chains of DHP derivatives.

Tunable nanoporous silicon oxide templates by swift heavy ion tracks technology

Nanoporous silicon oxide templates formed by swift heavy ion tracks technology have been investigated. The influence of the heavy ion characteristics, such as type of ion, energy, stopping power and irradiation fluence on the pore properties of the silicon oxide templates, has been studied. Furthermore, the process of pore formation by chemical etching with hydrofluoric acid has been thoroughly investigated by assessing the effect of etchant concentration and etching time. The outcome of this investigation enables us to have precise control over the resulting geometry of nanopores arrays. As a result, guidelines for the creation of a-SiO2/Si templates with tunable parameters and general recommendations for their further application are presented.

Positive-Themed Suicide Prevention Messages Delivered by Adolescent Peer Leaders: Proximal Impact on Classmates' Coping Attitudes and Perceptions of Adult Support

Developing science-based communication guidance and positive-themed messages for suicide prevention are important priorities. Drawing on social learning and elaboration likelihood models, we designed and tested two positive-focused presentations by high school peer leaders delivered in the context of a suicide prevention program (Sources of Strength). Thirty-six classrooms in four schools (N = 706 students) were randomized to (1) peer leader modeling of healthy coping, (2) peer leader modeling plus audience involvement to identify trusted adults, or (3) control condition. Students' attitudes and norms were assessed by immediate post-only assessments. Exposure to either presentation enhanced positive coping attitudes and perceptions of adult support. Students who reported suicide ideation in the past 12 months benefited more than nonsuicidal students. Beyond modeling alone, audience involvement modestly enhanced expectations of adult support, congruent with the elaboration likelihood model. Positive peer modeling is a promising alternative to communications focused on negative consequences and directives and may enhance social-interpersonal factors linked to reduced suicidal behaviors.

Clinical and Neuropsychological Differences between Mild Parkinson's Disease Dementia and Dementia with Lewy Bodies

BACKGROUND

The specific profile of dementia in Parkinson's disease (PDD) and dementia with Lewy bodies (DLB) in the earliest stages of dementia is still unclear and subject of considerable controversy.

METHODS

We investigated 27 PDD patients and 24 DLB patients with parkinsonism in the early stage of dementia, i.e. with a Mini-Mental State Examination score of ≥24.

RESULTS

Compared to PDD, patients with DLB demonstrated significantly lower scores when testing attention and executive functions [modified card sorting test (p < 0.001) and digit span backward (p < 0.02)], as well as when testing constructive abilities [copy of complex designs (p = 0.001) and pentagon (p < 0.001)]. Using logistic regression analysis, diagnosis was predicted from the cognitive profile, with an overall accuracy of 88.2%. In addition, PDD patients showed a significantly higher Unified Parkinson's Disease Rating Scale (UPDRS) motor subscore (p < 0.001) as well as higher UPDRS motor item scores [tremor at rest (p = 0.01) and bradykinesia (p = 0.001)].

CONCLUSIONS

The cognitive profile in PDD differs from that in DLB in the early stage of dementia, with worse performance on tests of attention and executive functions and constructive abilities in DLB compared to PDD patients. In contrast, motor symptoms are more severe in PDD than in DLB.

Neuropsychological and neuroimaging markers in prediction of cognitive impairment after ischemic stroke: a prospective follow-up study

BACKGROUND

There are few longitudinal studies with controversial results examining delayed changes in cognition after ischemic stroke and predictive values of neuropsychological and neuroimaging markers.

OBJECTIVE

The objectives of this study were to evaluate the delayed changes in cognition in poststroke patients and their relationship to the neuropsychological and neuroimaging markers measured during the acute poststroke phase.

METHODS

Eighty-five first-ever stroke inpatients (mean age 65.6±5.6 years) without previous cognitive complaints were prospectively evaluated with a comprehensive neuropsychological battery at the 5th day and the 1st, 6th, and 12th months. A wide range of clinical, radiological, and neuropsychological variables were examined.

RESULTS

Our results showed significantly poorer performance on mini-mental state examination, memory, attention/executive functions, and processing speed in patients with stroke in comparison with stroke-free cognitively intact controls. Multiple regression analysis revealed that hippocampal atrophy is the strongest predictor of delayed cognitive impairment. Secondary divided subgroups according to Isaacs Set Test (IST) score showed that patients with IST score ≤28 had different patterns of cognitive and neurological impairment after 1 year. Baseline impairments in attention/executive functions and memory were associated with development of dementia in poststroke patients.

CONCLUSION

Executive functioning deficit appears to have a predictive power for cognitive impairment progression. The study suggests that IST as a screening test has a potential to be a reliable and quick tool for poststroke cognitive impairment evaluation and delayed cognitive and neurological outcome. Hippocampal atrophy was the strongest predictor for cognitive impairment outcome, even in poststroke cognitive impairment. The findings may set the stage for better poststroke management.