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Guzmán-Cornejo C, Herrera-Mares A, García-Prieto L, Oceguera-Figueroa A, López-Pérez AM, Dzul-Rosado K. Potential zoonotic role of the tick Amblyomma cf. oblongoguttatum (Ixodida: Ixodidae) in the bacterial transmission of Ehrlichia chaffeensis (Rickettsiales: Anaplasmataceae) in a deciduous tropical forest in Mexico. J Med Entomol 2024:tjae047. [PMID: 38616043 DOI: 10.1093/jme/tjae047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/20/2024] [Accepted: 03/29/2024] [Indexed: 04/16/2024]
Abstract
Ehrlichia chaffeensis is a bacterium belonging to the Anaplasmataceae family. In Mexico, only 2 species have been recorded in association with tick species and humans. The objective of the present study was to detect the presence of bacteria of the genus Ehrlichia in ticks collected from the Chamela-Cuixmala Biosphere Reserve, Jalisco, Mexico. The collected ticks were identified and analyzed individually by polymerase chain reaction to amplify a fragment of the Anaplasmataceae 16S rRNA gene and the Ehrlichia-specific dsb gene. A total of 204 ticks, corresponding to 5 species of Ixodidae and 1 of Argasidae, were collected from 147 mammals of 6 species and 4 orders; 57 ticks collected from vegetation were also included. Among the total ticks collected, 1.47% (3/204) was positive for Ehrlichia sp. DNA was obtained using the primers EHR 16SD and EHR 16SR for 16S rRNA and DSB-330 and DSB-728 for dsb. The positive samples corresponded to a larva (Amblyomma sp.) associated with Didelphis virginiana and 2 nymphs (Amblyomma cf. oblongoguttatum) infesting Nasua narica. None of the ticks collected from the vegetation tested positive for Ehrlichia sp. DNA on the basis of the 16S rRNA and dsb genes. The sequences from the larvae of Amblyomma sp. and the nymphs of A. cf. oblongoguttatum were similar to those of E. chaffeensis. The phylogenetic analysis inferred with maximum likelihood corroborated the identity as E. chaffeensis. Although the role of these tick species as vectors of E. chaffeensis is still undetermined, the presence of infected ticks in the area indicates a potential zoonotic risk.
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Affiliation(s)
- Carmen Guzmán-Cornejo
- Laboratorio de Acarología, Departamento de Biología Comparada, Facultad de Ciencias, Universidad Nacional Autónoma de México, 04510, Ciudad de México, México
| | - Angel Herrera-Mares
- Laboratorio de Ecología de Enfermedades y Una Salud, Departamento de Etología, Fauna Silvestre y Animales de Laboratorio, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Luis García-Prieto
- Laboratorio de Helmintología, Departamento de Zoología, Instituto de Biología, Universidad Nacional Autónoma de México, 04510, Ciudad de México, México
| | - Alejandro Oceguera-Figueroa
- Laboratorio de Helmintología, Departamento de Zoología, Instituto de Biología, Universidad Nacional Autónoma de México, 04510, Ciudad de México, México
| | - Andrés M López-Pérez
- Red de Biología y Conservación de Vertebrados, Instituto de Ecología (INECOL A.C.), Veracruz, México
| | - Karla Dzul-Rosado
- Centro de Investigaciones Regionales "Dr. Hideyo Noguchi," Universidad Autónoma de Yucatán, Mérida, Yucatán, México
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Manto M, Mitoma H. Immune Ataxias: The Continuum of Latent Ataxia, Primary Ataxia and Clinical Ataxia. J Integr Neurosci 2024; 23:79. [PMID: 38682229 DOI: 10.31083/j.jin2304079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 05/01/2024] Open
Abstract
The clinical category of immune-mediated cerebellar ataxias (IMCAs) is now recognized after 3 decades of clinical and experimental research. The cerebellum gathers about 60% of neurons in the brain, is enriched in numerous plasticity mechanisms, and presents a large variety of antigens at the neuroglial level: ion channels and related proteins, synaptic adhesion/organizing proteins, transmitter receptors, and glial cells. Cerebellar circuitry is especially vulnerable to immune attacks. After the loss of immune tolerance, IMCAs present in an acute or subacute manner with various combinations of a vestibulocerebellar syndrome (VCS), a cerebellar motor syndrome (CMS), and a cerebellar cognitive affective syndrome/Schmahmann's syndrome (CCAS/SS). IMCAs include gluten ataxia (GA), post-infectious cerebellitis (PIC), Miller Fisher syndrome (MFS), paraneoplastic cerebellar degeneration (PCD), opsoclonus myoclonus syndrome (OMS), anti-glutamic acid decarboxylase (anti-GAD) ataxia, and glial fibrillary acidic protein (GFAP) astrocytopathy (GFAP-A). In addition, multiple sclerosis (MS), acute disseminated encephalomyelitis (ADEM), Behçet disease, and collagen-vascular disorders may also present with cerebellar symptoms when lesions involve cerebellar afferences/efferences. Patients whose clinical profiles do not fit with IMCAs are now gathered in the group of primary autoimmune cerebellar ataxias (PACAs). Latent auto-immune cerebellar ataxia (LACA) refers to a clinical stage with a slow progressive course and a lack of obvious auto-immune background. At a pre-symptomatic stage, patients remain asymptomatic, whereas at the prodromal stage aspecific symptoms occur, announcing the symptomatic neuronal loss. LACA corresponds to a time-window where an intervention could lead to preservation of plasticity mechanisms. Patients may evolve from LACA to PACA and typical IMCAs, highlighting a continuum. Immune ataxias represent a model to elucidate the sequence of events leading to destruction of cerebellar neuronal reserve and develop novel strategies aiming to restore plasticity mechanisms.
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Affiliation(s)
- Mario Manto
- Service de Neurologie, CHU-Charleroi, 6000 Charleroi, Belgium
- Service des Neurosciences, University of Mons, 7000 Mons, Belgium
| | - Hiroshi Mitoma
- Department of Medical Education, Tokyo Medical University, 160-0023 Tokyo, Japan
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Li P, Gao C, Yu L, Gao L, Cai R, Bennett DA, Schneider JA, Buchman AS, Hu K. Delineating cognitive resilience using fractal regulation: Cross-sectional and longitudinal evidence from the Rush Memory and Aging Project. Alzheimers Dement 2024. [PMID: 38497429 DOI: 10.1002/alz.13747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Degradation of fractal patterns in actigraphy independently predicts dementia risk. Such observations motivated the study to understand the role of fractal regulation in the context of neuropathologies. METHODS We examined associations of fractal regulation with neuropathologies and longitudinal cognitive changes in 533 older participants who were followed annually with actigraphy and cognitive assessments until death with brain autopsy performed. Two measures for fractal patterns were extracted from actigraphy, namely, α1 (representing the fractal regulation at time scales of <90 min) and α2 (for time scales 2 to 10 h). RESULTS We found that larger α1 was associated with lower burdens of Lewy body disease or cerebrovascular disease pathologies; both α1 and α2 were associated with cognitive decline. They explained an additional significant portion of the variance in the rate of cognitive decline above and beyond neuropathologies. DISCUSSION Fractal patterns may be used as a biomarker for cognitive resilience against dementia-related neuropathologies.
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Affiliation(s)
- Peng Li
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Chenlu Gao
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Lei Gao
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Ruixue Cai
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Kun Hu
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Medical Biodynamics Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
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Lücker P, Henning E, Kästner A, Hoffmann W. Inactive nurses' willingness to return to active nursing during the COVID-19 pandemic: A qualitative study. J Adv Nurs 2024; 80:1043-1057. [PMID: 37775954 DOI: 10.1111/jan.15881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 07/16/2023] [Accepted: 09/11/2023] [Indexed: 10/01/2023]
Abstract
AIMS To investigate factors that influence the willingness of inactive nurses to return to nursing in a crisis situation and to identify aspects that need to be considered with regard to a possible deployment. DESIGN A deductive and inductive qualitative content analysis of semi-structured focus group interviews. METHODS Semi-structured focus group interviews with inactive or marginally employed nurses, nurses who have been inactive for some time and nursing home managers in October and November 2021. The participating inactive nurses had declared their willingness for a deployment during the COVID-19 pandemic or not. Data were analysed using qualitative content analysis. RESULTS Communication was seen as essential by the participants for an informed decision for or against a temporary return to nursing and to potential or actual deployments. To make them feel safe, inactive nurses need to know what to expect and what is expected of them, for example, regarding required training and responsibilities. Considering their current employment status, some flexibility in terms of deployment conditions is needed. A remaining attachment to care can trigger a sense of duty. Knowledge of (regular) working conditions in nursing can lead to both a desire to support former colleagues and a refusal to be exposed to these conditions again. CONCLUSION Past working experiences and the current employment situation play a major role in the willingness of inactive nurses to return to nursing in a crisis situation. Unbureaucratic arrangements must be provided for those who are willing to return. SUMMARY STATEMENT What already is known - In crisis situations, not every inactive nurse is willing or able to return to nursing and therefore, the 'silent reserve' may not be as large as suspected. What this paper adds - Inactive nurses need to know what to expect and what is expected of them for their decision regarding a return to active patient care during a crisis situation. Implications for practice/policy - Inactive nurses need to be informed and should be offered free training and refresher courses to ensure patient safety. IMPACT This research shows that the group of inactive nurses are not a silent workforce which can be activated anytime. Those who are able and willing to return to direct patient care in crisis situations need the best possible support - during and between crises. REPORTING METHOD This study adhered to COREQ guidelines. NO PATIENT OR PUBLIC CONTRIBUTION The involvement of patients or members of the public did not apply for the study, as the aim was to gain insight into the motivations and attitudes of the group of inactive nurses.
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Affiliation(s)
- Petra Lücker
- Department Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Esther Henning
- Department Methods of Community Medicine, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anika Kästner
- Department Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- Department Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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Szemán K, Végvári Z, Gőri S, Kapocsi I, Székely T, Manning JA. Harem size should be measured by more than the sum of its parts: Phenology-based measurements reveal joint effects of intrinsic and extrinsic factors on a polygamous herbivore under non-stationary climatic conditions. Ecol Evol 2024; 14:e10865. [PMID: 38322007 PMCID: PMC10844713 DOI: 10.1002/ece3.10865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 09/02/2023] [Accepted: 01/16/2024] [Indexed: 02/08/2024] Open
Abstract
Social behaviour is thought to be a major component of survival, reproduction, and resilience of populations. Thus, it is a key component in management and conservation of wild populations. In polygynous breeding species, group size influences the reproductive success of males and females, and hence it is essential to understand the environmental and demographic factors that shape the phenology of group size within populations. Here, we investigate harem size and its determinants using a 15-year dataset of annual harem size phenology-based metrics from a reintroduced population of wild Przewalski horses in Hortobágy National Park, Hungary. From the initial reintroduction of 21 animals in 1997, the population grew to 174 animals in 2012. During that same period, the number of harems increased from three to 23. Despite the 8-fold increase in population size, harem sizes remained stable, and variability among harems within years decreased. The annual phenological cycle of harem size was not consistent over the 15-year period, and the associated annual phenology-based metrics varied differently over the years. The best predictors of our phenology-based harem size metrics were adult sex ratio, annual adult mortality and annual mean number of harems, with some evidence that mean age of harem stallions and drought severity were contributing factors. Our findings reveal that complex interactions between demography, climate, and harem size can emerge in social animals. Taken together, our results demonstrate that intrinsic population processes can regulate group size even in the presence of non-stationary climatic conditions during periods of growth in human-introduced, semi-free ranging animal populations.
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Affiliation(s)
- Karola Szemán
- Department of Evolutionary Zoology and Human BiologyUniversity of DebrecenDebrecenHungary
| | - Zsolt Végvári
- Centre for Ecological ResearchInstitute of Aquatic EcologyBudapestHungary
- Senckenberg Deutsches Entomologisches InstitutMunchebergGermany
| | - Szilvia Gőri
- Hortobágy National Park DirectorateDebrecenHungary
| | | | - Tamás Székely
- Department of Evolutionary Zoology and Human BiologyUniversity of DebrecenDebrecenHungary
- Milner Centre of EvolutionUniversity of BathBathUK
| | - Jeffrey A. Manning
- School of the Environment, Washington State UniversityPullmanWashingtonUSA
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Wills O, Probst Y. Towards new perspectives: A scoping review and meta-synthesis to redefine brain health for multiple sclerosis. Eur J Neurol 2024:e16210. [PMID: 38226556 DOI: 10.1111/ene.16210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/03/2023] [Accepted: 12/28/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND AND PURPOSE Research promoting the health of the brain has increased exponentially over the last decade. The importance of 'brain health' for multiple sclerosis (MS), as one example, is a high priority. However, as research into the concept increases, so does varied use of the term. METHODS A scoping review, guided by the methodological framework of the Joanna Briggs Institute, was conducted to collate the evidence relating to brain health for MS. A comprehensive literature search incorporated six search strategies to retrieve both scientific and grey literature sources. All evidence sources were qualitatively charted and synthesized (meta-synthesis) according to their definition of brain health used, outcome measures and brain-healthy lifestyle elements. RESULTS Seventy evidence sources (34 peer reviewed, 36 grey literature) were eligible for inclusion. Of these, just over half (n = 40, 57%) provided a definition of brain health. The most common definition alluded to the biomedical model of neurological reserve (n = 22, 55%), a self-remodelling theory described to retain optimal brain function. Twenty-nine outcome measures of brain health were identified, the most frequent being magnetic resonance imaging metrics (n = 25, 83%). Physical activity was the most prevalent brain-healthy lifestyle element (n = 44), followed by avoidance of smoking (n = 26) and diet (n = 24). CONCLUSIONS Brain health should be considered a primary target for optimal disease and lifestyle management across the MS disease course. A working definition reflecting a shift from a medical lens towards broader biopsychosocial contexts that may influence brain health for people living with MS is proposed.
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Affiliation(s)
- Olivia Wills
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
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Darwish Elhajji F, Abuhasheesh S, Al Rusasi A, Aldeyab MA. Overview of Availability, Cost, and Affordability of Antibiotics for Adults in Jordan: An AWaRe Classification Perspective. Antibiotics (Basel) 2023; 12:1576. [PMID: 37998778 PMCID: PMC10668667 DOI: 10.3390/antibiotics12111576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
Antimicrobial resistance (AMR) poses a global public health threat, with rates directly linked with consumption. The World Health Organization (WHO)'s AWaRe classification aims to guide antibiotic use, and is influenced by drug availability, affordability, and economic policies. In Jordan, a high proportion of consumed antibiotics belong to the 'Watch' category. Data from the WHO's AWaRe classification, the Essential Medicines List, and the Jordan Food and Drug Administration were analyzed. Antibiotics for adults were classified, their costs per defined daily dose (DDD) were determined and their affordability assessed. In 2023, 43 injectable and 43 oral antibiotics for adults were registered in Jordan. 'Watch' antibiotics were the most common. 'Access' antibiotics had the lowest cost/DDD. 'Reserve' antibiotics were the most expensive, with few generics. Injectable antibiotics had a negative correlation between cost and the number of alternatives. Affordability was higher for oral antibiotics compared with injectable ones. 'Reserve' antibiotics were generally unaffordable. This study highlights the need to promote 'Access' antibiotics over other categories by encouraging the registration of missing 'Access' antibiotics and adjusting the prices of 'Watch' and 'Reserve' antibiotics. Competition among generics can lead to lower prices, increasing affordability and accessibility. We emphasize the importance of the AWaRe classification in guiding antibiotic use in Jordan.
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Affiliation(s)
| | | | | | - Mamoon A. Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK;
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Dzwiza-Ohlsen EN, Kempermann G. The embodied mind in motion: a neuroscientific and philosophical perspective on prevention and therapy of dementia. Front Psychol 2023; 14:1174424. [PMID: 37663337 PMCID: PMC10471310 DOI: 10.3389/fpsyg.2023.1174424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/24/2023] [Indexed: 09/05/2023] Open
Abstract
The embodied mind in motion is a concept in which health and well-being, prevention and therapy, as well as lifestyle and habits meet. The mind changes profoundly in the course of dementias, affecting daily living and resulting in reduced quality of life. Interdisciplinary approaches are required for a holistic understanding of how the mind is affected by dementia. We here explore what such a holistic theory of dementia might look like and propose the idea of "embodied mind in motion". The paradigm is biopsychosocial or biocultural, the theoretical anchor point is the lifeworld, and the guiding concept is "embodiment," as body and mind are constantly in motion. Physical activity is, hence, central for the experience of health and well-being, beyond being "exercise" and "health behavior". We discuss the embodied mind in motion referring to phenomenology, enactivism and (philosophical) anthropology. In our view, habits are embodied long-term memories and a philosophical equivalent to lifestyle. They unfold the meaningfulness of moving the body, complementing the objectifiable benefits of physical exercise. Empirical studies on "holistic activities" like hiking, yoga, music and dance illustrate improved integration into everyday life. Their meaningfulness enhances compliance and increases the preventive and even therapeutic potential. A crucial factor for this is the emotional dimension of lifestyle, exemplified by the virally popularized performance of "Swan Lake" by wheel-chair bound ex-ballerina Marta Cinta González Saldaña, suffering from Alzheimer's disease. A number of epistemological and ontological consequences anchor "embodied movement" as a valuable principle for dementia research.
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Affiliation(s)
- Erik N. Dzwiza-Ohlsen
- Faculty of Arts and Humanities, Husserl Archives Cologne, University of Cologne, Cologne, Germany
| | - Gerd Kempermann
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
- CRTD – Center for Regenerative Therapies, TU Dresden, Dresden, Germany
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Fraile E, Gagnepain P, Eustache F, Groussard M, Platel H. Musical experience prior to traumatic exposure as a resilience factor: a conceptual analysis. Front Psychol 2023; 14:1220489. [PMID: 37599747 PMCID: PMC10436084 DOI: 10.3389/fpsyg.2023.1220489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023] Open
Abstract
Resilience mechanisms can be dynamically triggered throughout the lifecourse by resilience factors in order to prevent individuals from developing stress-related pathologies such as posttraumatic stress disorder (PTSD). Some interventional studies have suggested that listening to music and musical practice after experiencing a traumatic event decrease the intensity of PTSD, but surprisingly, no study to our knowledge has explored musical experience as a potential resilience factor before the potential occurrence of a traumatic event. In the present conceptual analysis, we sought to summarize what is known about the concept of resilience and how musical experience could trigger two key mechanisms altered in PTSD: emotion regulation and cognitive control. Our hypothesis is that the stimulation of these two mechanisms by musical experience during the pre-traumatic period could help protect against the symptoms of emotional dysregulation and intrusions present in PTSD. We then developed a new framework to guide future research aimed at isolating and investigating the protective role of musical experience regarding the development of PTSD in response to trauma. The clinical application of this type of research could be to develop pre-trauma training that promotes emotional regulation and cognitive control, aimed at populations at risk of developing PTSD such as healthcare workers, police officers, and military staffs.
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Manto M, Cendelin J, Strupp M, Mitoma H. Advances in cerebellar disorders: pre-clinical models, therapeutic targets, and challenges. Expert Opin Ther Targets 2023; 27:965-987. [PMID: 37768297 DOI: 10.1080/14728222.2023.2263911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 09/24/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Cerebellar ataxias (CAs) represent neurological disorders with multiple etiologies and a high phenotypic variability. Despite progress in the understanding of pathogenesis, few therapies are available so far. Closing the loop between preclinical studies and therapeutic trials is important, given the impact of CAs upon patients' health and the roles of the cerebellum in multiple domains. Because of a rapid advance in research on CAs, it is necessary to summarize the main findings and discuss future directions. AREAS COVERED We focus our discussion on preclinical models, cerebellar reserve, the therapeutic management of CAs, and suitable surrogate markers. We searched Web of Science and PubMed using keywords relevant to cerebellar diseases, therapy, and preclinical models. EXPERT OPINION There are many symptomatic and/or disease-modifying therapeutic approaches under investigation. For therapy development, preclinical studies, standardization of disease evaluation, safety assessment, and demonstration of clinical improvements are essential. Stage of the disease and the level of the cerebellar reserve determine the goals of the therapy. Deficits in multiple categories and heterogeneity of CAs may require disease-, stage-, and symptom-specific therapies. More research is needed to clarify how therapies targeting the cerebellum influence both basal ganglia and the cerebral cortex, poorly explored domains in CAs.
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Affiliation(s)
- Mario Manto
- Service des Neurosciences, University of Mons, Mons, Belgium
| | - Jan Cendelin
- Department of Pathophysiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Michael Strupp
- Department of Neurology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany
| | - Hiroshi Mitoma
- Department of Medical Education, Tokyo medical University, Tokyo, Japan
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Abu-Ajaleh S, Darwish Elhajji F, Al-Bsoul S, Abu Farha R, Al-Hammouri F, Amer A, Al Rusasi A, Al-Azzam S, Araydah M, Aldeyab MA. An Evaluation of the Impact of Increasing the Awareness of the WHO Access, Watch, and Reserve (AWaRe) Antibiotics Classification on Knowledge, Attitudes, and Hospital Antibiotic Prescribing Practices. Antibiotics (Basel) 2023; 12:951. [PMID: 37370270 DOI: 10.3390/antibiotics12060951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
The study aims to determine the effect of enhancing knowledge and awareness of the WHO Access, Watch, and Reserve (AWaRe) antibiotics classification on hospital clinical staff's knowledge, attitudes and antibiotic prescribing practices. A pre-post-intervention study design was employed. The intervention was an educational activity that involved teaching physicians and pharmacists about the AWaRe classification and the risk of antibiotic resistance. A questionnaire was administered to clinical staff pre-and post-intervention. In the pre-interventional stage, 78.5% of participants stated they had not heard about the AWaRe classification of antibiotics. After receiving the intervention: the knowledge regarding the meaning and purpose of AWaRe classification of antibiotics increased from 39.1% to 75.4%; the percentage of participants who agreed with following the AWaRe classification of antibiotics in their practice increased from 21.7% to 58.5%; and the percentage of participants who agreed that AWaRe classification of antibiotics can suggest safe choices of antibiotics increased from 56.5% to 90.8%. Hospital antibiotic use of the Access group increased by 6.6% from pre- to post-intervention. The use of the Watch group and Reserve group decreased post-intervention by 1.7%, and 43.1%, respectively. This study showed important gaps in knowledge and attitudes towards AWaRe, highlighting the need for increasing the awareness of the AWaRe tool amongst healthcare practitioners to ensure rational use of antibiotics.
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Affiliation(s)
- Salam Abu-Ajaleh
- Faculty of Pharmacy, Applied Science Private University, 166, Amman 11193, Jordan
| | | | | | - Rana Abu Farha
- Faculty of Pharmacy, Applied Science Private University, 166, Amman 11193, Jordan
| | | | - Amer Amer
- The Specialty Hospital, 930186, Amman 11193, Jordan
| | | | - Sayer Al-Azzam
- Clinical Pharmacy Department, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | | | - Mamoon A Aldeyab
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
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Berry AS, Harrison TM. New perspectives on the basal forebrain cholinergic system in Alzheimer's disease. Neurosci Biobehav Rev 2023; 150:105192. [PMID: 37086935 DOI: 10.1016/j.neubiorev.2023.105192] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/27/2023] [Accepted: 03/28/2023] [Indexed: 04/24/2023]
Abstract
The basal forebrain cholinergic system (BFCS) has long been implicated in age-related cognitive changes and the pathophysiology of Alzheimer's disease (AD). Limitations of cholinergic interventions helped to inspire a shift away from BFCS in AD research. A resurgence in interest in the BFCS following methodological and analytical advances has resulted in a call for the BFCS to be examined in novel frameworks. We outline the basic structure and function of the BFCS, its role in supporting cognitive and affective function, and its vulnerability to aging and AD. We consider the BFCS in the context of the amyloid hypothesis and evolving concepts in AD research: resilience and resistance to pathology, selective neuronal vulnerability, trans-synaptic pathology spread and sleep health. We highlight 1) the potential role of the BFCS in cognitive resilience, 2) recent work refining understanding about the selective vulnerability of BFCS to AD, 3) BFCS connectivity that suggests it is related to tau spreading and neurodegeneration and 4) the gap between BFCS involvement in AD and sleep-wake cycles.
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Affiliation(s)
- Anne S Berry
- Brandeis University, Waltham, Massachusetts, 02453.
| | - Theresa M Harrison
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, California, 94720
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13
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Mungmunpuntipantip R, Wiwanitkit V. Copeptin, the prediction of poor ovarian reserve and the infertile women: Correspondence. Turk J Obstet Gynecol 2023; 20:85. [PMID: 36908107 PMCID: PMC10013079 DOI: 10.4274/tjod.galenos.2023.57946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
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14
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Rojas Albert A, Backhaus W, Graterol Pérez JA, Braaβ H, Schön G, Choe CU, Feldheim J, Bönstrup M, Cheng B, Thomalla G, Gerloff C, Schulz R. Cortical thickness of contralesional cortices positively relates to future outcome after severe stroke. Cereb Cortex 2022; 32:5622-5627. [PMID: 35169830 DOI: 10.1093/cercor/bhac040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 01/25/2023] Open
Abstract
Imaging studies have evidenced that contralesional cortices are involved in recovery after motor stroke. Cortical thickness (CT) analysis has proven its potential to capture the changes of cortical anatomy, which have been related to recovery and treatment gains under therapy. An open question is whether CT obtained in the acute phase after stroke might inform correlational models to explain outcome variability. Data of 38 severely impaired (median NIH Stroke Scale 9, interquartile range: 6-13) acute stroke patients of 2 independent cohorts were reanalyzed. Structural imaging data were processed via the FreeSurfer pipeline to quantify regional CT of the contralesional hemisphere. Ordinal logistic regression models were fit to relate CT to modified Rankin Scale as an established measure of global disability after 3-6 months, adjusted for the initial deficit, lesion volume, and age. The data show that CT of contralesional cortices, such as the precentral gyrus, the superior frontal sulcus, and temporal and cingulate cortices, positively relates to the outcome after stroke. This work shows that the baseline cortical anatomy of selected contralesional cortices can explain the outcome variability after severe stroke, which further contributes to the concept of structural brain reserve with respect to contralesional cortices to promote recovery.
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Affiliation(s)
- Alina Rojas Albert
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Winifried Backhaus
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - José A Graterol Pérez
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Hanna Braaβ
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Gerhard Schön
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Chi-Un Choe
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Jan Feldheim
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Marlene Bönstrup
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany.,Department of Neurology, University Medical Center, Leipzig 04103, Germany
| | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Robert Schulz
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
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15
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Sadeghihassanabadi F, Frey BM, Backhaus W, Choe CU, Zittel S, Schön G, Bönstrup M, Cheng B, Thomalla G, Gerloff C, Schulz R. Structural cerebellar reserve positively influences outcome after severe stroke. Brain Commun 2022; 4:fcac203. [PMID: 36337341 PMCID: PMC9629400 DOI: 10.1093/braincomms/fcac203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/30/2022] [Accepted: 08/02/2022] [Indexed: 12/25/2022] Open
Abstract
The concept of brain reserve capacity positively influencing the process of recovery after stroke has been continuously developed in recent years. Global measures of brain health have been linked with a favourable outcome. Numerous studies have evidenced that the cerebellum is involved in recovery after stroke. However, it remains an open question whether characteristics of cerebellar anatomy, quantified directly after stroke, might have an impact on subsequent outcome after stroke. Thirty-nine first-ever ischaemic non-cerebellar stroke patients underwent MRI brain imaging early after stroke and longitudinal clinical follow-up. Structural images were used for volumetric analyses of distinct cerebellar regions. Ordinal logistic regression analyses were conducted to associate cerebellar volumes with functional outcome 3-6 months after stroke, operationalized by the modified Rankin Scale. Larger volumes of cerebellar lobules IV, VI, and VIIIB were positively correlated with favourable outcome, independent of the severity of initial impairment, age, and lesion volume (P < 0.01). The total cerebellar volume did not exhibit a significant structure-outcome association. The present study reveals that pre-stroke anatomy of distinct cerebellar lobules involved in motor and cognitive functioning might be linked to outcome after acute non-cerebellar stroke, thereby promoting the emerging concepts of structural brain reserve for recovery processes after stroke.
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Affiliation(s)
| | - Benedikt M Frey
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Winifried Backhaus
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Chi-un Choe
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Simone Zittel
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Gerhard Schön
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Marlene Bönstrup
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany,Department of Neurology, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Bastian Cheng
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Robert Schulz
- Correspondence to: Robert Schulz MD University Medical Center Hamburg-Eppendorf Martinistraße 52, 20246 Hamburg, Germany E-mail:
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Gonneaud J, Moreau I, Felisatti F, Arenaza-Urquijo E, Ourry V, Touron E, de la Sayette V, Vivien D, Chételat G. Men and women show partly distinct effects of physical activity on brain integrity. Alzheimers Dement (Amst) 2022; 14:e12302. [PMID: 35382233 PMCID: PMC8959639 DOI: 10.1002/dad2.12302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 01/04/2022] [Accepted: 01/16/2022] [Indexed: 12/14/2022]
Abstract
Introduction Physical inactivity and female sex are independently associated with increased Alzheimer's disease (AD) lifetime risk. This study investigates the possible interactions between sex and physical activity on neuroimaging biomarkers. Methods In 134 cognitively unimpaired older adults (≥65 years, 82 women) from the Age‐Well randomized controlled trial (baseline data), we investigated the association between physical activity and multimodal neuroimaging (gray matter volume, glucose metabolism, perfusion, and amyloid burden), and how sex modulates these associations. Results The anterior cingulate cortex volume was independently associated with sex and physical activity. Sex and physical activity interacted on perfusion and amyloid deposition in medial parietal regions, such that physical activity was related to perfusion only in women, and to amyloid burden only in men. Discussion Physical activity has both sex‐dependent and sex‐independent associations with brain integrity. Our findings highlight partly distinct reserve mechanisms in men and women, which might in turn influence their risk of AD. Highlights Sex and physical activity have been linked to Alzheimer's disease (AD) progression. The association of sex and physical activity with brain health is partly independent. Different reserve mechanisms exist in men and women.
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Affiliation(s)
- Julie Gonneaud
- Normandie Université Université de Caen Institut National de la Santé et de la Recherche Médicale Unité 1237 "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain@ Caen-Normandie GIP Cyceron Caen France
| | - Ilana Moreau
- Normandie Université Université de Caen Institut National de la Santé et de la Recherche Médicale Unité 1237 "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain@ Caen-Normandie GIP Cyceron Caen France
| | - Francesca Felisatti
- Normandie Université Université de Caen Institut National de la Santé et de la Recherche Médicale Unité 1237 "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain@ Caen-Normandie GIP Cyceron Caen France
| | - Eider Arenaza-Urquijo
- Normandie Université Université de Caen Institut National de la Santé et de la Recherche Médicale Unité 1237 "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain@ Caen-Normandie GIP Cyceron Caen France.,Barcelonabeta Brain Research Center Fundación Pasqual Maragall Barcelona Spain
| | - Valentin Ourry
- Normandie Université Université de Caen Institut National de la Santé et de la Recherche Médicale Unité 1237 "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain@ Caen-Normandie GIP Cyceron Caen France.,Normandie Univ UNICAEN, PSL Université EPHE, INSERM, U1077 CHU de Caen GIP Cyceron NIMH Caen France
| | - Edelweiss Touron
- Normandie Université Université de Caen Institut National de la Santé et de la Recherche Médicale Unité 1237 "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain@ Caen-Normandie GIP Cyceron Caen France
| | - Vincent de la Sayette
- Normandie Univ UNICAEN, PSL Université EPHE, INSERM, U1077 CHU de Caen GIP Cyceron NIMH Caen France.,Service de Neurologie Centre Hospitalier Universitaire de Caen Caen France
| | - Denis Vivien
- Normandie Université Université de Caen Institut National de la Santé et de la Recherche Médicale Unité 1237 "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain@ Caen-Normandie GIP Cyceron Caen France
| | - Gaël Chételat
- Normandie Université Université de Caen Institut National de la Santé et de la Recherche Médicale Unité 1237 "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain@ Caen-Normandie GIP Cyceron Caen France
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17
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Bansal A, Sharma R, Prakash R. Adoption of the World Health Organization access, watch reserve index to evaluate and monitor the use of antibiotics at a tertiary care hospital in India. Perspect Clin Res 2022; 13:90-93. [PMID: 35573458 PMCID: PMC9106137 DOI: 10.4103/picr.picr_202_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 11/29/2022] Open
Abstract
Background The World Health Organization classification of antibiotics classifies key antibiotics into access, watch, and reserve (AWaRe) categories. Categorization provides a novel metrics called "AWaRe index" to study and monitor antibiotic consumption globally and within the same setting over time. Aim The aim of this study is to compare the use of antibiotics in 2 years using the AWaRe index tool. Materials and Methods A retrospective study was conducted in SMS Hospital, Jaipur to collect data regarding total antibiotics consumed between January 2017 and December 2018 from drug distribution centers in hospital premises using the AWaRe classification. Data were then compared on yearly basis. Results In 2017, 53.31% of antibiotics consumed belonged to access, 40.09% to watch, and 3.40% to reserve category, respectively, as compared to 41.21%, 46.94%, and 8.15%, respectively, in 2018. Conclusion Increased use of watch (17%) and reserve antibiotics (140%) over 1 year with the same infection scenario in a similar setting indicates resistance in evolution.
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Affiliation(s)
- Alka Bansal
- Department of Pharmacology, SMS Medical College, Jaipur, Rajasthan, India
| | - Rajni Sharma
- Department of Microbiology, SMS Medical College, Jaipur, Rajasthan, India
| | - Ravi Prakash
- Department of Medicine, SMS Medical College, Jaipur, Rajasthan, India
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18
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Williams NG, Gorey KM, Alberton AM. Motor vehicle collision-related injuries and deaths among Indigenous Peoples in Canada: Meta-analysis of geo-structural factors. Can J Rural Med 2022; 27:51-60. [PMID: 35343182 DOI: 10.4103/cjrm.cjrm_42_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction Indigenous Peoples are much more likely than non-Indigenous Peoples to be seriously injured or die in motor vehicle collisions (MVCs). This study updates and extends a previous systematic review, suggesting that future research ought to incorporate social-environmental factors. Methods We conducted a systematic review and meta-analysis of the published and grey literature on MVCs involving Indigenous Peoples in Canada between 2010 and 2020. We focussed on personal (e.g. driving an old vehicle) and community social-environmental-economic factors (e.g. prevalent low socioeconomic status). Results Eleven comparative cohorts that resulted in 23 at minimum, age-standardised, mortality or morbidity rate outcomes were included in our meta-analysis. Indigenous Peoples were twice as likely as non-Indigenous Peoples to be seriously injured (rate ratio [RRpooled] = 2.18) and more than 3 times as likely to die (RRpooled = 3.40) in MVCs. Such great risks to Indigenous Peoples do not seem to have diminished over the past generation. Furthermore, such risks were greater on-reserves and in smaller, rural and remote, places. Conclusion Such places may lack community resources, including fewer transportation and healthcare infrastructural investments, resulting in poorer road conditions in Indigenous communities and longer delays to trauma care. This seems to add further evidence of geo-structural violence (geographical and institutional violence) perpetrated against Indigenous Peoples in yet more structures (i.e. institutions) of Canadian society. Canada's system of highways and roadways and its remote health-care system represent legitimate policy targets in aiming to solve this public health problem.
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Affiliation(s)
| | - Kevin M Gorey
- School of Social Work, University of Windsor, Ontario, Canada
| | - Amy M Alberton
- School of Social Work, Wichita State University, Wichita, Kansas, USA
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19
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Mansouri G, Safinataj M, Shahesmaeili A, Allahqoli L, Salehiniya H, Alkatout I. Effect of laparoscopic cystectomy on ovarian reserve in patients with ovarian cyst. Front Endocrinol (Lausanne) 2022; 13:964229. [PMID: 36120464 PMCID: PMC9476315 DOI: 10.3389/fendo.2022.964229] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/11/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the effect of laparoscopic cystectomy on ovarian reserve in patients with ovarian cysts. MATERIAL AND METHODS This prospective study was performed on 113 women with ovarian cysts in a tertiary referral teaching hospital. All patients underwent laparoscopic cystectomy. Serum levels of antimüllerian hormone (AMH) were measured pre-and, 3 months postoperatively. The primary outcome of the study was to assess the effect of laparoscopic cystectomy on ovarian reserve based on alterations in serum AMH levels. The secondary outcome of the present study was to evaluate the impact of the number of cauterizations, size and type of cysts, bilaterality (bilateral or unilateral), age, and body mass index (BMI) on the ovarian reserve after laparoscopic excision. RESULTS Laparoscopic cystectomy reduced the serum AMH levels preoperatively (1.32 ± 4.48 ng/ml) to postoperatively (3.2 ± 1.93 ng/ml) and the difference (- 1.28 ng/ml) was statistically different (0.001 >P). There was a negative significant relationship between the number of cauterizations used and postoperative serum AMH levels (p ≤ 0.001). There was a significant relationship between the location (p ≤ 0.01), type of cyst (p ≤ 0.001) and the serum AMH levels reduction. CONCLUSION The number of cauterizations used during surgery, the type of cyst, and bilaterality can affect AMH levels that need to be addressed.
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Affiliation(s)
- Ghazal Mansouri
- Department of Obstetrics and Gynecology, School of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Safinataj
- Department of Obstetrics and Gynecology, School of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
- *Correspondence: Ibrahim Alkatout, ; Maryam Safinataj,
| | - Armita Shahesmaeili
- HIV/STI Surveillance Research Center, and World Health Organization (WHO) Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Leila Allahqoli
- Midwifery Department, Ministry of Health and Medical Education, Tehran, Iran
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Kiel, Germany
- *Correspondence: Ibrahim Alkatout, ; Maryam Safinataj,
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20
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Bagarinao E, Watanabe H, Maesawa S, Kawabata K, Hara K, Ohdake R, Ogura A, Mori D, Yoneyama N, Imai K, Yokoi T, Kato T, Koyama S, Katsuno M, Wakabayashi T, Kuzuya M, Hoshiyama M, Isoda H, Naganawa S, Ozaki N, Sobue G. Reserve and Maintenance in the Aging Brain: A Longitudinal Study of Healthy Older Adults. eNeuro 2022; 9:ENEURO. [PMID: 35045976 DOI: 10.1523/ENEURO.0455-21.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/22/2021] [Accepted: 01/03/2022] [Indexed: 11/24/2022] Open
Abstract
The aging brain undergoes structural changes even in very healthy individuals. Quantifying these changes could help disentangle pathologic changes from those associated with the normal human aging process. Using longitudinal magnetic resonance imaging (MRI) data from 227 carefully selected healthy human cohort with age ranging from 50 to 80 years old at baseline scan, we quantified age-related volumetric changes in the brain of healthy human older adults. Longitudinally, the rates of tissue loss in total gray matter (GM) and white matter (WM) were 2497.5 and 2579.8 mm3 per year, respectively. Across the whole brain, the rates of GM decline varied with regions in the frontal and parietal lobes having faster rates of decline, whereas some regions in the occipital and temporal lobes appeared relatively preserved. In contrast, cross-sectional changes were mainly observed in the temporal-occipital regions. Similar longitudinal atrophic changes were also observed in subcortical regions including thalamus, hippocampus, putamen, and caudate, whereas the pallidum showed an increasing volume with age. Overall, regions maturing late in development (frontal, parietal) are more vulnerable to longitudinal decline, whereas those that fully mature in the early stage (temporal, occipital) are mainly affected by cross-sectional changes in healthy older cohort. This may suggest that, for a successful healthy aging, the former needs to be maximally developed at an earlier age to compensate for the longitudinal decline later in life and the latter to remain relatively preserved even in old age, consistent with both concepts of reserve and brain maintenance.
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21
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Ndubuka N, Klaver B, Gupta S, Lamichhane S, Brooks L, Nelson S, Akinjobi G. Descriptive analysis of a tuberculosis outbreak from a northern Saskatchewan First Nations community-December 2018 to May 2019. Can Commun Dis Rep 2021; 47:479-84. [PMID: 35330954 DOI: 10.14745/ccdr.v47i11a07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background The tuberculosis (TB) incidence rate for northern Saskatchewan First Nations on-reserve is 1.5 higher than the national average. In December 2018 a member of one of these communities was diagnosed with 4+ smear-positive TB, spurring an outbreak investigation. Objectives To describe the public health response to TB outbreak investigation and highlight the risk factors associated with TB transmission in northern Saskatchewan; and to highlight the relevance of social network contact investigation tool in outbreak management. Methods Descriptive analysis included active TB cases and latent TB infection (LTBI) cases linked by contact investigation to the index case. Data were collected from active TB case files. Statistical analyses were performed and social network analysis conducted using household locations as points of contact between cases. Results A total of eight active TB cases and 41 LTBI cases were identified as part of the outbreak between December 2018 and May 2019. Half of the cases (4/8) were 25 to 34 years old, and five were smear negative. One-third of the people with LTBI were 15 to 24 years old, and about a half tested positive to the new tuberculin skin test (TST). The commonly reported risk factors for TB and LTBI cases were alcohol use, cigarette use, marijuana use, previous TB infection and homelessness. Social network analysis indicated a relationship between increased node centrality and becoming an active case. Conclusion Real-time social network contact investigation used in active-case finding was very successful in identifying cases, and enhanced nursing support, mobile clinics and mobile X-ray worked well as a means of confirming cases and offering treatment. TB outbreaks in northern Saskatchewan First Nations on-reserve communities are facilitated by population-specific factors. Efforts to implement context-specific interventions are paramount in managing TB outbreaks and preventing future transmission.
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22
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Schauer SG, April MD, Arana AA, Maddry JK, Escandon MA, Linscomb CD, Rodriguez DC, Convertino VA. Efficacy of the compensatory reserve measurement in an emergency department trauma population. Transfusion 2021; 61 Suppl 1:S174-S182. [PMID: 34269446 DOI: 10.1111/trf.16498] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND The Compensatory Reserve Measurement (CRM) is a novel method used to provide early assessment of shock based on arterial wave form morphology changes. We hypothesized that (1) CRM would be significantly lower in those trauma patients who received life-saving interventions compared with those not receiving interventions, and (2) CRM in patients who received interventions would recover after the intervention was performed. STUDY DESIGN AND METHODS We captured vital signs along with analog arterial waveform data from trauma patients meeting major activation criteria using a prospective study design. Study team members tracked interventions throughout their emergency department stay. RESULTS Ninety subjects met inclusion with 13 receiving a blood product and 10 a major airway intervention. Most trauma was blunt (69%) with motor vehicle collisions making up the largest proportion (37%) of injury mechanism. Patients receiving blood products had lower CRM values just prior to administration versus those who did not (50% versus 58%, p = .045), and lower systolic pressure (SBP; 95 versus 123 mmHg, p = .005), diastolic (DBP; 62 versus 79, p = .007), and mean arterial pressure (MAP; 75 versus 95, p = .006), and a higher pulse rate (HR; 101 versus 89 bpm, p = .039). Patients receiving an airway intervention had lower CRM values just prior to administration versus those who did not (48% versus 58%, p = .062); however, SBP, DBP, MAP, and HR were not statistically distinguishable (p ≥ .645). CONCLUSIONS Our results support our hypotheses that the CRM distinguished those patients who received blood or an airway intervention from those who did not, and increased appropriately after interventions were performed.
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Affiliation(s)
- Steven G Schauer
- US Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas, USA.,Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas, USA.,Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Michael D April
- 2nd Brigade, 4th Infantry Division, Fort Carson, Colorado, USA
| | - Allyson A Arana
- Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas, USA
| | - Joseph K Maddry
- US Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas, USA.,Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas, USA.,Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,59th Medical Wing, JBSA Lackland, San Antonio, Texas, USA
| | - Mireya A Escandon
- Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas, USA
| | | | - Dylan C Rodriguez
- Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas, USA
| | - Victor A Convertino
- US Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas, USA.,Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Department of Emergency Medicine, University of Texas Heath, San Antonio, Texas, USA
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23
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Plini ERG, O’Hanlon E, Boyle R, Sibilia F, Rikhye G, Kenney J, Whelan R, Melnychuk MC, Robertson IH, Dockree PM. Examining the Role of the Noradrenergic Locus Coeruleus for Predicting Attention and Brain Maintenance in Healthy Old Age and Disease: An MRI Structural Study for the Alzheimer's Disease Neuroimaging Initiative. Cells 2021; 10:1829. [PMID: 34359997 PMCID: PMC8306442 DOI: 10.3390/cells10071829] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 12/18/2022] Open
Abstract
The noradrenergic theory of Cognitive Reserve (Robertson, 2013-2014) postulates that the upregulation of the locus coeruleus-noradrenergic system (LC-NA) originating in the brainstem might facilitate cortical networks involved in attention, and protracted activation of this system throughout the lifespan may enhance cognitive stimulation contributing to reserve. To test the above-mentioned theory, a study was conducted on a sample of 686 participants (395 controls, 156 mild cognitive impairment, 135 Alzheimer's disease) investigating the relationship between LC volume, attentional performance and a biological index of brain maintenance (BrainPAD-an objective measure, which compares an individual's structural brain health, reflected by their voxel-wise grey matter density, to the state typically expected at that individual's age). Further analyses were carried out on reserve indices including education and occupational attainment. Volumetric variation across groups was also explored along with gender differences. Control analyses on the serotoninergic (5-HT), dopaminergic (DA) and cholinergic (Ach) systems were contrasted with the noradrenergic (NA) hypothesis. The antithetic relationships were also tested across the neuromodulatory subcortical systems. Results supported by Bayesian modelling showed that LC volume disproportionately predicted higher attentional performance as well as biological brain maintenance across the three groups. These findings lend support to the role of the noradrenergic system as a key mediator underpinning the neuropsychology of reserve, and they suggest that early prevention strategies focused on the noradrenergic system (e.g., cognitive-attentive training, physical exercise, pharmacological and dietary interventions) may yield important clinical benefits to mitigate cognitive impairment with age and disease.
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Affiliation(s)
- Emanuele R. G. Plini
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
| | - Erik O’Hanlon
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
- Department of Psychiatry, Royal College of Surgeons in Ireland, Hospital Rd, Beaumont, 9QRH+4F Dublin, Ireland
- Department of Psychiatry, School of Medicine Dublin, Trinity College Dublin, 152-160 Pearse St, 8QV3+99 Dublin, Ireland;
| | - Rory Boyle
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
| | - Francesca Sibilia
- Department of Psychiatry, School of Medicine Dublin, Trinity College Dublin, 152-160 Pearse St, 8QV3+99 Dublin, Ireland;
| | - Gaia Rikhye
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
| | - Joanne Kenney
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
| | - Robert Whelan
- Department of Psychology, Global Brain Health Institute, Trinity College Dublin, Lloyd Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland;
| | - Michael C. Melnychuk
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
| | - Ian H. Robertson
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
- Department of Psychology, Global Brain Health Institute, Trinity College Dublin, Lloyd Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland;
| | - Paul M. Dockree
- Department of Psychology, Trinity College Institute of Neuroscience, Trinity College Dublin, Llyod Building, 42A Pearse St, 8PVX+GJ Dublin, Ireland; (E.O.); (R.B.); (G.R.); (J.K.); (M.C.M.); (I.H.R.); (P.M.D.)
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24
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Yang K, Chen G, Sheng C, Xie Y, Li Y, Hu X, Sun Y, Han Y. Cognitive Reserve, Brain Reserve, APOEɛ4, and Cognition in Individuals with Subjective Cognitive Decline in the SILCODE Study. J Alzheimers Dis 2021; 76:249-260. [PMID: 32444543 DOI: 10.3233/jad-200082] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cognitive reserve (CR) and brain reserve (BR) could offer protective effects on cognition in the early stage of Alzheimer's disease (AD). However, the effects of CR or BR on cognition in individuals with subjective cognitive decline (SCD) are not clear. OBJECTIVE To explore the effects of CR and BR on cognition in subjects with SCD. METHODS We included 149 subjects from the Sino Longitudinal Study on Cognitive Decline (SILCODE) study. Education was used as a proxy for CR, and head circumference was used as a proxy for BR. Multiple linear regression models were conducted to examine the effects of CR and BR on cognitive scores. Furthermore, we assessed differences in effects between APOEɛ4 carriers with SCD (n = 35) and APOEɛ4 non-carriers with SCD (n = 114) and linear trends among 4 reserve levels (low BR/CR, high BR/low CR, low BR/high CR, and high BR/high CR). RESULTS Both CR and BR had independent positive effects on multiple cognitive measures in SCD participants, and the effects of CR were greater than those of BR. CR has positive effects on cognitive measures in both APOEɛ4 carriers and non-carriers with SCD. However, the positive effects of BR on cognitive measures were observed in APOEɛ4 non-carriers with SCD but not in APOEɛ4 carriers with SCD. Furthermore, there was a linear trend toward better cognitive performance on all cognitive measures in the BR+/CR+ group, followed by the BR-/CR+, BR+/CR-, and BR-/CR-groups. CONCLUSION This study suggests that both CR and BR have the potential to delay or slow cognitive decline in individuals with SCD.
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Affiliation(s)
- Kun Yang
- Department of Evidence-based Medicine, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Guanqun Chen
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Can Sheng
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Yunyan Xie
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Yuxia Li
- Central Laboratory, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaochen Hu
- Department of Psychiatry and Psychotherapy, University of Cologne, Medical Faculty, Cologne, Germany
| | - Yu Sun
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Ying Han
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China
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25
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Nyberg L, Magnussen F, Lundquist A, Baaré W, Bartrés-Faz D, Bertram L, Boraxbekk CJ, Brandmaier AM, Drevon CA, Ebmeier K, Ghisletta P, Henson RN, Junqué C, Kievit R, Kleemeyer M, Knights E, Kühn S, Lindenberger U, Penninx BWJH, Pudas S, Sørensen Ø, Vaqué-Alcázar L, Walhovd KB, Fjell AM. Educational attainment does not influence brain aging. Proc Natl Acad Sci U S A 2021; 118:e2101644118. [PMID: 33903255 PMCID: PMC8106299 DOI: 10.1073/pnas.2101644118] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Education has been related to various advantageous lifetime outcomes. Here, using longitudinal structural MRI data (4,422 observations), we tested the influential hypothesis that higher education translates into slower rates of brain aging. Cross-sectionally, education was modestly associated with regional cortical volume. However, despite marked mean atrophy in the cortex and hippocampus, education did not influence rates of change. The results were replicated across two independent samples. Our findings challenge the view that higher education slows brain aging.
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Affiliation(s)
- Lars Nyberg
- Department of Radiation Sciences, Radiology, Umeå University, 901 87 Umeå, Sweden;
- Department of Integrative Medical Biology, Umeå University, 901 87 Umeå, Sweden
- Umeå Center for Functional Brain Imaging, Umeå University, 901 87 Umeå, Sweden
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0317 Oslo, Norway
| | - Fredrik Magnussen
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0317 Oslo, Norway
| | - Anders Lundquist
- Umeå Center for Functional Brain Imaging, Umeå University, 901 87 Umeå, Sweden
| | - William Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, 2650 Hvidovre, Denmark
| | - David Bartrés-Faz
- Department of Medicine, Faculty of Medicine and Health Sciences and Neurosciences Institute, University of Barcelona, 08014 Barcelona, Spain
| | - Lars Bertram
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0317 Oslo, Norway
- Lübeck Interdisciplinary Platform for Genome Analytics, University of Lübeck, 23538 Lübeck, Germany
| | - C J Boraxbekk
- Department of Radiation Sciences, Radiology, Umeå University, 901 87 Umeå, Sweden
- Umeå Center for Functional Brain Imaging, Umeå University, 901 87 Umeå, Sweden
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, 2650 Hvidovre, Denmark
- Institute of Sports Medicine Copenhagen, Copenhagen University Hospital, Bispebjerg, 2400 Copenhagen, Denmark
| | - Andreas M Brandmaier
- Center for Lifespan Psychology, Max Planck Institute for Human Development, D-14195 Berlin, Germany
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, D-14195 Berlin, Germany, and London WC1B 5EH, United Kingdom
| | - Christian A Drevon
- Vitas AS, Research Park, 0349 Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, Medicine/University of Oslo, 0317 Oslo, Norway
| | - Klaus Ebmeier
- Warneford Hospital, University of Oxford, Oxford OX3 7JX, United Kingdom
| | - Paolo Ghisletta
- Faculté de Psychologie et des Sciences de l'Education, Université de Genève, 1205 Geneva, Switzerland
| | - Richard N Henson
- Medical Research Council Cognition and Brain Sciences Unit, Department of Psychiatry, University of Cambridge, Cambridge CB2 7EF, United Kingdom
| | - Carme Junqué
- Department of Medicine, Faculty of Medicine and Health Sciences and Neurosciences Institute, University of Barcelona, 08014 Barcelona, Spain
| | - Rogier Kievit
- Medical Research Council Cognition and Brain Sciences Unit, Department of Psychiatry, University of Cambridge, Cambridge CB2 7EF, United Kingdom
- Cognitive Neuroscience Department, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, 6500 GL Nijmegen, The Netherlands
| | - Maike Kleemeyer
- Center for Lifespan Psychology, Max Planck Institute for Human Development, D-14195 Berlin, Germany
| | - Ethan Knights
- Medical Research Council Cognition and Brain Sciences Unit, Department of Psychiatry, University of Cambridge, Cambridge CB2 7EF, United Kingdom
| | - Simone Kühn
- Center for Lifespan Psychology, Max Planck Institute for Human Development, D-14195 Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Clinic Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Ulman Lindenberger
- Center for Lifespan Psychology, Max Planck Institute for Human Development, D-14195 Berlin, Germany
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, D-14195 Berlin, Germany, and London WC1B 5EH, United Kingdom
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit, 1081 HJ Amsterdam, The Netherlands
| | - Sara Pudas
- Department of Integrative Medical Biology, Umeå University, 901 87 Umeå, Sweden
- Umeå Center for Functional Brain Imaging, Umeå University, 901 87 Umeå, Sweden
| | - Øystein Sørensen
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0317 Oslo, Norway
| | - Lídia Vaqué-Alcázar
- Department of Medicine, Faculty of Medicine and Health Sciences and Neurosciences Institute, University of Barcelona, 08014 Barcelona, Spain
| | - Kristine B Walhovd
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0317 Oslo, Norway
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, 0372 Oslo, Norway
| | - Anders M Fjell
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, 0317 Oslo, Norway;
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, 0372 Oslo, Norway
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26
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Ewers M, Luan Y, Frontzkowski L, Neitzel J, Rubinski A, Dichgans M, Hassenstab J, Gordon BA, Chhatwal JP, Levin J, Schofield P, Benzinger TLS, Morris JC, Goate A, Karch CM, Fagan AM, McDade E, Allegri R, Berman S, Chui H, Cruchaga C, Farlow M, Graff-Radford N, Jucker M, Lee JH, Martins RN, Mori H, Perrin R, Xiong C, Rossor M, Fox NC, O'Connor A, Salloway S, Danek A, Buerger K, Bateman RJ, Habeck C, Stern Y, Franzmeier N. Segregation of functional networks is associated with cognitive resilience in Alzheimer's disease. Brain 2021; 144:2176-2185. [PMID: 33725114 DOI: 10.1093/brain/awab112] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/26/2020] [Accepted: 12/29/2020] [Indexed: 11/14/2022] Open
Abstract
Cognitive resilience is an important modulating factor of cognitive decline in Alzheimer's disease, but the functional brain mechanisms that support cognitive resilience remain elusive. Given previous findings in normal ageing, we tested the hypothesis that higher segregation of the brain's connectome into distinct functional networks represents a functional mechanism underlying cognitive resilience in Alzheimer's disease. Using resting-state functional MRI, we assessed both resting-state functional MRI global system segregation, i.e. the balance of between-network to within-network connectivity, and the alternate index of modularity Q as predictors of cognitive resilience. We performed all analyses in two independent samples for validation: (i) 108 individuals with autosomal dominantly inherited Alzheimer's disease and 71 non-carrier controls; and (ii) 156 amyloid-PET-positive subjects across the spectrum of sporadic Alzheimer's disease and 184 amyloid-negative controls. In the autosomal dominant Alzheimer's disease sample, disease severity was assessed by estimated years from symptom onset. In the sporadic Alzheimer's sample, disease stage was assessed by temporal lobe tau-PET (i.e. composite across Braak stage I and III regions). In both samples, we tested whether the effect of disease severity on cognition was attenuated at higher levels of functional network segregation. For autosomal dominant Alzheimer's disease, we found higher functional MRI-assessed system segregation to be associated with an attenuated effect of estimated years from symptom onset on global cognition (P = 0.007). Similarly, for patients with sporadic Alzheimer's disease, higher functional MRI-assessed system segregation was associated with less decrement in global cognition (P = 0.001) and episodic memory (P = 0.004) per unit increase of temporal lobe tau-PET. Confirmatory analyses using the alternate index of modularity Q revealed consistent results. In conclusion, higher segregation of functional connections into distinct large-scale networks supports cognitive resilience in Alzheimer's disease.
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Affiliation(s)
- Michael Ewers
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Ying Luan
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany
| | - Lukas Frontzkowski
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany
| | - Julia Neitzel
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany
| | - Anna Rubinski
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster for Systems Neurology, SyNergy, Ludwig-Maximilian-University LMU, Munich, Germany
| | - Jason Hassenstab
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
| | - Brian A Gordon
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
| | - Jasmeer P Chhatwal
- Massachusetts General Hospital, Department of Neurology, Harvard Medical School, MA, USA
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Peter Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Tammie L S Benzinger
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - John C Morris
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Alison Goate
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Ronald M. Loeb Center for Alzheimer's Disease, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Celeste M Karch
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO, USA
| | - Anne M Fagan
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO, USA
| | - Eric McDade
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Ricardo Allegri
- Department of Neurology, FLENI Fondation, Buenos Aires, Argentina
| | - Sarah Berman
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Helena Chui
- Alzheimer's Disease Research Center, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA.,Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carlos Cruchaga
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.,Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO, USA.,NeuroGenomics and Informatics, Washington University School of Medicine, St. Louis, MO, USA
| | - Marty Farlow
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Mathias Jucker
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Department of Cellular Neurology, Hertie Institute for Clinical Brain Research, Tübingen, Germany.,Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ralph N Martins
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Australian Alzheimer's Research Foundation, Ralph and Patricia Sarich Neuroscience Research Institute, Nedlands, WA, Australia.,Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia.,KaRa Institute of Neurological Diseases, Sydney, NSW, Australia
| | - Hiroshi Mori
- Department of Clinical Neuroscience, Osaka City University Medical School, Osaka, Japan
| | - Richard Perrin
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO, USA.,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Chengjie Xiong
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Biostatistics, Washington University, St Louis, MO, USA
| | - Martin Rossor
- Dementia Research Centre, University College London, Queen Square, London, UK
| | - Nick C Fox
- Dementia Research Centre, University College London, Queen Square, London, UK
| | - Antoinette O'Connor
- Dementia Research Centre, University College London, Queen Square, London, UK.,UK Dementia Research Institute at UCL, UCL, London, UK
| | - Stephen Salloway
- Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Randall J Bateman
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA.,Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Christian Habeck
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York, NY, USA
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilian-University LMU, Munich, Germany
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27
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Davis JRC, Knight SP, Donoghue OA, Hernández B, Rizzo R, Kenny RA, Romero-Ortuno R. Comparison of Gait Speed Reserve, Usual Gait Speed, and Maximum Gait Speed of Adults Aged 50+ in Ireland Using Explainable Machine Learning. Front Netw Physiol 2021; 1:754477. [PMID: 36925580 PMCID: PMC10013005 DOI: 10.3389/fnetp.2021.754477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/15/2021] [Indexed: 12/28/2022]
Abstract
Gait speed is a measure of general fitness. Changing from usual (UGS) to maximum (MGS) gait speed requires coordinated action of many body systems. Gait speed reserve (GSR) is defined as MGS-UGS. From a shortlist of 88 features across five categories including sociodemographic, cognitive, and physiological, we aimed to find and compare the sets of predictors that best describe UGS, MGS, and GSR. For this, we leveraged data from 3,925 adults aged 50+ from Wave 3 of The Irish Longitudinal Study on Ageing (TILDA). Features were selected by a histogram gradient boosting regression-based stepwise feature selection pipeline. Each model's feature importance and input-output relationships were explored using TreeExplainer from the Shapely Additive Explanations explainable machine learning package. The mean R a d j 2 (SD) from fivefold cross-validation on training data and the R a d j 2 score on test data were 0.38 (0.04) and 0.41 for UGS, 0.45 (0.04) and 0.46 for MGS, and 0.19 (0.02) and 0.21 for GSR. Each model selected features across all categories. Features common to all models were age, grip strength, chair stands time, mean motor reaction time, and height. Exclusive to UGS and MGS were educational attainment, fear of falling, Montreal cognitive assessment errors, and orthostatic intolerance. Exclusive to MGS and GSR were body mass index (BMI), and number of medications. No features were selected exclusively for UGS and GSR. Features unique to UGS were resting-state pulse interval, Center for Epidemiologic Studies Depression Scale (CESD) depression, sit-to-stand difference in diastolic blood pressure, and left visual acuity. Unique to MGS were standard deviation in sustained attention to response task times, resting-state heart rate, smoking status, total heartbeat power during paced breathing, and visual acuity. Unique to GSR were accuracy proportion in a sound-induced flash illusion test, Mini-mental State Examination errors, and number of cardiovascular conditions. No interactions were present in the GSR model. The four features that overall gave the most impactful interactions in the UGS and MGS models were age, chair stands time, grip strength, and BMI. These findings may help provide new insights into the multisystem predictors of gait speed and gait speed reserve in older adults and support a network physiology approach to their study.
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Affiliation(s)
- James R C Davis
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Silvin P Knight
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Orna A Donoghue
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Belinda Hernández
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rossella Rizzo
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.,Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Roman Romero-Ortuno
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland.,Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.,Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
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28
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Romero-Ortuño R, Martínez-Velilla N, Sutton R, Ungar A, Fedorowski A, Galvin R, Theou O, Davies A, Reilly RB, Claassen J, Kelly ÁM, Ivanov PC. Network Physiology in Aging and Frailty: The Grand Challenge of Physiological Reserve in Older Adults. Front Netw Physiol 2021; 1:712430. [PMID: 36925570 PMCID: PMC10012993 DOI: 10.3389/fnetp.2021.712430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 06/25/2021] [Indexed: 12/29/2022]
Affiliation(s)
- Román Romero-Ortuño
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.,Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland.,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Nicolás Martínez-Velilla
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Public University of Navarra (UPNA), Navarra Health Research Institute (IdisNa), Pamplona, Spain
| | - Richard Sutton
- Faculty of Medicine, Imperial College London, Heart Science, National Heart and Lung Institute, London, United Kingdom
| | - Andrea Ungar
- Geriatric Department, University of Florence and Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Artur Fedorowski
- Department of Clinical Sciences, Lund University and Department of Cardiology, Skåne University Hospital, Malmo, Sweden
| | - Rose Galvin
- Ageing Research Centre, School of Allied Health, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Olga Theou
- Physiotherapy and Geriatric Medicine, Dalhousie University, Halifax, NS, Canada
| | - Andrew Davies
- School of Medicine, Trinity College Dublin, University College Dublin and Our Lady's Hospice and Care Services, Dublin, Ireland
| | - Richard B Reilly
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.,Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin, Ireland
| | - Jurgen Claassen
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Áine M Kelly
- Discipline of Physiology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Plamen Ch Ivanov
- Keck Laboratory for Network Physiology, Boston University, Boston, MA, United States
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Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease, for which aging remains the major risk factor. Aging is under a consistent pressure of increasing brain entropy (BEN) due to the progressive brain deteriorations. Noticeably, the brain constantly consumes a large amount of energy to maintain its functional integrity, likely creating or maintaining a big "reserve" to counteract the high entropy. Malfunctions of this latent reserve may indicate a critical point of disease progression. The purpose of this study was to characterize BEN in aging and AD and to test an inverse-U-shape BEN model: BEN increases with age and AD pathology in normal aging but decreases in the AD continuum. BEN was measured with resting state fMRI and compared across aging and the AD continuum. Associations of BEN with age, education, clinical symptoms, and pathology were examined by multiple regression. The analysis results highlighted resting BEN in the default mode network, medial temporal lobe, and prefrontal cortex and showed that: (1) BEN increased with age and pathological deposition in normal aging but decreased with age and pathological deposition in the AD continuum; (2) AD showed catastrophic BEN reduction, which was related to more severe cognitive impairment and daily function disability; and (3) BEN decreased with education years in normal aging, but not in the AD continuum. BEN evolution follows an inverse-U trajectory when AD progresses from normal aging to AD dementia. Education is beneficial for suppressing the entropy increase potency in normal aging.
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Affiliation(s)
- Ze Wang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, United States
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Sei Y, Feng J, Zhao X, Wank SA. Role of an active reserve stem cell subset of enteroendocrine cells in intestinal stem cell dynamics and the genesis of small intestinal neuroendocrine tumors. Am J Physiol Gastrointest Liver Physiol 2020; 319:G494-G501. [PMID: 32845170 PMCID: PMC7654644 DOI: 10.1152/ajpgi.00278.2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Small intestinal neuroendocrine tumors (SI-NET) are serotonin-secreting well-differentiated neuroendocrine tumors of putative enterochromaffin (EC) cell origin. Recent studies recognize a subset of EC cells that is label-retaining at the +4 position in the crypt and functions as a reserve intestinal stem cell. Importantly, this +4 reserve EC cell subset not only contributes to regeneration of the intestinal epithelium during injury and inflammation but also to basal crypt homeostasis at a constant rate. The latter function suggests that the +4 EC cell subset serves as an active reserve stem cell via a constant rate of dedifferentiation. Characterization of early tumor formation of SI-NET, observed as crypt-based EC cell clusters in many cases of familial SI-NETs, suggests that the +4 active reserve EC cell subset is the cell of origin. This newly discovered active reserve stem cell property of EC cells can account for unique biological mechanisms and processes associated with the genesis and development of SI-NETs. The recognition of this property of the +4 active reserve EC cell subset may provide novel opportunities to explore NETs in the gastrointestinal tract and other organs.
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Affiliation(s)
- Yoshitatsu Sei
- Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Jianying Feng
- Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Xilin Zhao
- Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Stephen A. Wank
- Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
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31
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Abdelazim IA, Zhurabekova G. Reversible decreased ovarian reserve after conservative ovarian surgery for benign lesion other than endometrioma - case report. Prz Menopauzalny 2020; 19:104-7. [PMID: 32802021 DOI: 10.5114/pm.2020.97869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 03/28/2020] [Indexed: 12/02/2022]
Abstract
A 36-year-old woman presented with abdominal pain and diagnosed provisionally as complicated ovarian cyst. The trans-vaginal ultrasound (TVS) done for the studied woman showed, well-defined solid mass, measuring 10 × 8 cm related to the anterior uterine wall most probably subserous uterine leiomyoma or ovarian fibroma. The TVS finding of left solid mass was confirmed by the magnetic resonance imaging (MRI). At laparotomy, the solid mass was originating from the left ovary and the right ovary and uterus were completely normal. The left ovarian mass excised (confirmed as ovarian fibroma by histological examination), and more than half of the left ovary was preserved during surgery. The pre-operative ovarian reserve hormones, anti-Müllerian hormone (AMH), follicle stimulating hormone (FSH), and luteinizing hormone (LH) were completely normal. Post-operative follow-up of the studied woman showed regular menstrual rhythm and duration, elevated FSH and LH for one year after surgery and both the FSH and LH returned to normal levels at the end of the first post-operative year. This report represents the finding of reversible decrease ovarian reserve (RDOR) after conservative ovarian surgery for benign lesion other than endometrioma to minimise normal ovarian tissue damage during surgery as much as possible and to counsel women at risk of DOR that any ovarian surgery may be associated with further decrease in the ovarian reserve and reproductive ability.
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32
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Dumitrescu L, Mahoney ER, Mukherjee S, Lee ML, Bush WS, Engelman CD, Lu Q, Fardo DW, Trittschuh EH, Mez J, Kaczorowski C, Hernandez Saucedo H, Widaman KF, Buckley R, Properzi M, Mormino E, Yang HS, Harrison T, Hedden T, Nho K, Andrews SJ, Tommet D, Hadad N, Sanders RE, Ruderfer DM, Gifford KA, Moore AM, Cambronero F, Zhong X, Raghavan NS, Vardarajan B, Pericak-Vance MA, Farrer LA, Wang LS, Cruchaga C, Schellenberg G, Cox NJ, Haines JL, Keene CD, Saykin AJ, Larson EB, Sperling RA, Mayeux R, Bennett DA, Schneider JA, Crane PK, Jefferson AL, Hohman TJ. Genetic variants and functional pathways associated with resilience to Alzheimer's disease. Brain 2020; 143:2561-2575. [PMID: 32844198 PMCID: PMC7447518 DOI: 10.1093/brain/awaa209] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/22/2020] [Accepted: 05/08/2020] [Indexed: 12/23/2022] Open
Abstract
Approximately 30% of older adults exhibit the neuropathological features of Alzheimer's disease without signs of cognitive impairment. Yet, little is known about the genetic factors that allow these potentially resilient individuals to remain cognitively unimpaired in the face of substantial neuropathology. We performed a large, genome-wide association study (GWAS) of two previously validated metrics of cognitive resilience quantified using a latent variable modelling approach and representing better-than-predicted cognitive performance for a given level of neuropathology. Data were harmonized across 5108 participants from a clinical trial of Alzheimer's disease and three longitudinal cohort studies of cognitive ageing. All analyses were run across all participants and repeated restricting the sample to individuals with unimpaired cognition to identify variants at the earliest stages of disease. As expected, all resilience metrics were genetically correlated with cognitive performance and education attainment traits (P-values < 2.5 × 10-20), and we observed novel correlations with neuropsychiatric conditions (P-values < 7.9 × 10-4). Notably, neither resilience metric was genetically correlated with clinical Alzheimer's disease (P-values > 0.42) nor associated with APOE (P-values > 0.13). In single variant analyses, we observed a genome-wide significant locus among participants with unimpaired cognition on chromosome 18 upstream of ATP8B1 (index single nucleotide polymorphism rs2571244, minor allele frequency = 0.08, P = 2.3 × 10-8). The top variant at this locus (rs2571244) was significantly associated with methylation in prefrontal cortex tissue at multiple CpG sites, including one just upstream of ATPB81 (cg19596477; P = 2 × 10-13). Overall, this comprehensive genetic analysis of resilience implicates a putative role of vascular risk, metabolism, and mental health in protection from the cognitive consequences of neuropathology, while also providing evidence for a novel resilience gene along the bile acid metabolism pathway. Furthermore, the genetic architecture of resilience appears to be distinct from that of clinical Alzheimer's disease, suggesting that a shift in focus to molecular contributors to resilience may identify novel pathways for therapeutic targets.
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Affiliation(s)
- Logan Dumitrescu
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Emily R Mahoney
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Michael L Lee
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - William S Bush
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Corinne D Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Qiongshi Lu
- Department of Statistics, University of Wisconsin-Madison, Madison, WI, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA
| | - David W Fardo
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Emily H Trittschuh
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
- VA Puget Sound Health Care System, GRECC, Seattle, WA, USA
| | - Jesse Mez
- Deparment of Neurology, Boston University School of Medicine, Boston, MA, USA
| | | | - Hector Hernandez Saucedo
- UC Davis Alzheimer’s Disease Research Center, Department of Neurology, University of California Davis Medical Center, Sacramento, CA, USA
| | | | - Rachel Buckley
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital/Harvard Medical School, Boston, MA, USA
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Michael Properzi
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Elizabeth Mormino
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Hyun-Sik Yang
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Center for Alzheimer’s Research and Treatment, Department of Neurology, Brigham and Women’s Hospital/Harvard Medical School, Boston, MA, USA
| | - Tessa Harrison
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Trey Hedden
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Kwangsik Nho
- Department of Radiology and Imaging Sciences, Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Shea J Andrews
- Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Doug Tommet
- Department of Psychiatry and Human Behavior, Brown University School of Medicine, Providence, RI, USA
| | | | | | - Douglas M Ruderfer
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Katherine A Gifford
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Annah M Moore
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Francis Cambronero
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Xiaoyuan Zhong
- Department of Statistics, University of Wisconsin-Madison, Madison, WI, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA
| | - Neha S Raghavan
- Department of Neurology, Columbia University, New York, NY, USA
- The Taub Institute for Research on Alzheimer’s Disease and The Aging Brain, Columbia University, New York, NY, USA
- The Institute for Genomic Medicine, Columbia University Medical Center and The New York Presbyterian Hospital, New York, NY, USA
| | - Badri Vardarajan
- Department of Neurology, Columbia University, New York, NY, USA
- The Taub Institute for Research on Alzheimer’s Disease and The Aging Brain, Columbia University, New York, NY, USA
- The Institute for Genomic Medicine, Columbia University Medical Center and The New York Presbyterian Hospital, New York, NY, USA
| | | | | | - Margaret A Pericak-Vance
- John P. Hussman Institute for Human Genomics, University of Miami School of Medicine, Miami, FL, USA
| | - Lindsay A Farrer
- Deparment of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, MA, USA
| | - Li-San Wang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Gerard Schellenberg
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Nancy J Cox
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jonathan L Haines
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - C Dirk Keene
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Eric B Larson
- Department of Medicine, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Richard Mayeux
- Department of Neurology, Columbia University, New York, NY, USA
- The Taub Institute for Research on Alzheimer’s Disease and The Aging Brain, Columbia University, New York, NY, USA
- The Institute for Genomic Medicine, Columbia University Medical Center and The New York Presbyterian Hospital, New York, NY, USA
| | - David A Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Angela L Jefferson
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Timothy J Hohman
- Vanderbilt Memory and Alzheimer’s Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
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Consolee KT, Gao C, Vitekere K, Li C, Yan H, Jiang G. Human-Leopard Conflict: An Emerging Issue of North China Leopard Conservation in Tieqiaoshan Provincial Nature Reserve in Shanxi Province, China. Animals (Basel) 2020; 10:ani10060996. [PMID: 32517372 PMCID: PMC7341223 DOI: 10.3390/ani10060996] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/29/2020] [Accepted: 06/03/2020] [Indexed: 11/30/2022] Open
Abstract
Simple Summary One of the main conservation issues, both locally and globally, is the issue of human-wildlife conflict. Losses of livestock due to predation by carnivores such as leopards has become a common problem. Residents share negative attitudes toward leopards due to conflicts over the depredation of livestock. Using data obtained from League Cat Forest Department records, and standardized, structured and semi-structured questionnaires, we found that the north China leopard was in serious conflict with the locals, causing them personal economic losses. Residents noted that the species was very dangerous to their livestock, causing them economic loss, and wanted to reduce or even eliminate it from their area. Abstract Livestock depredation by large carnivores is a conventional human–wildlife conflict, both at the local and regional level. Many species of wildlife have become endangered because of this conflict. In this study, an investigation of livestock depredation was conducted for the north China leopard in and around Tieqiaoshan Provincial Nature Reserve in Shanxi Province between 2015 and 2018. Data were obtained from League Cat Forest Department records. Additionally, standardized, structured, and semi-structured questionnaires were used to collect data with the help of reserve field staff. The results show that there was a significant difference (p = 0.015) in livestock depredation in various seasons of the year; the highest depredation was recorded in spring, followed by summer. A significant difference (p = 0.02) was observed between cattle and other livestock species, showing that more cattle were killed by the north China leopard. Most of the livestock depredation occurred during late morning and evening, likely because the leopards are crepuscular. Residents in and around the reserve suffered a high economic loss, ranging between RMB 5000 and 10,000 (USD 706.76–1413.53) per year in terms of the estimated market price of the killed livestock. The attitudes of residents towards the north China leopard vary according to the economic activities of the locals, with about 76% of the livestock keepers reporting that the leopard is “very dangerous” and 8% of the arable farmers in and around the reserve indicating that leopard is “very dangerous.” We recommend that a system with local participants would ensure more effective management of human-north China leopard conflict, as it would allow local communities to take greater responsibility.
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Affiliation(s)
- Kahindo Tulizo Consolee
- College of Wildlife and Natural Protected Areas, Northeast Forestry University, Harbin 150040, China; (K.T.C.); (C.G.); (K.V.); (C.L.)
| | - Chunyv Gao
- College of Wildlife and Natural Protected Areas, Northeast Forestry University, Harbin 150040, China; (K.T.C.); (C.G.); (K.V.); (C.L.)
| | - Kasereka Vitekere
- College of Wildlife and Natural Protected Areas, Northeast Forestry University, Harbin 150040, China; (K.T.C.); (C.G.); (K.V.); (C.L.)
| | - Chunshi Li
- College of Wildlife and Natural Protected Areas, Northeast Forestry University, Harbin 150040, China; (K.T.C.); (C.G.); (K.V.); (C.L.)
| | - Hua Yan
- Guangdong Provincial Key Laboratory of Silviculture, Protection and Utilization, Guangdong Academy of Forestry, Guangzhou 510520, China
- Correspondence: (H.Y.); (G.J.); Tel.: +86-02087031245 (H.Y.); +86-45182190279 (G.J.)
| | - Guangshun Jiang
- College of Wildlife and Natural Protected Areas, Northeast Forestry University, Harbin 150040, China; (K.T.C.); (C.G.); (K.V.); (C.L.)
- Correspondence: (H.Y.); (G.J.); Tel.: +86-02087031245 (H.Y.); +86-45182190279 (G.J.)
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Chen M, Chen J, Xu X, Qiao F, Wang X, Ji S, Gu Z, Chhetri JK, Chan P. Education Moderates the Association of Probable REM Sleep Behavior Disorder With Cognitive and Motor Impairments in Community-Dwelling Older People. Front Neurol 2020; 11:109. [PMID: 32184754 PMCID: PMC7059092 DOI: 10.3389/fneur.2020.00109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 01/30/2020] [Indexed: 01/12/2023] Open
Abstract
Objectives: To investigate the relationship between probable rapid eye movement (REM) sleep behavior disorder (pRBD) and cognitive/motor impairments in a community-dwelling population and explore the moderating effects of education. Methods: In this cross-sectional study of the Beijing Longitudinal Study of Aging II (BLSA II), 4,477 subjects (≥55 years) fulfilled the inclusion criteria. pRBD was determined by the RBD Questionnaire-Hong Kong (RBDQ-HK). Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to test the global cognitive performance. Walking speed was used to measure motor function. Logistic regression was performed to assess the relationship between pRBD and cognitive/motor impairments and the moderating effects of education. Results: There were 147 participants (3.3%) with pRBD. Participants with pRBD showed increased risks for cognitive impairment [odds ratio (OR) = 1.88, 95% CI 1.24-2.85, p = 0.003], decreased gait speed (OR = 1.43, 95% CI 1.02-2.01, p = 0.03), but not for mild cognitive impairment (MCI) (measured by MoCA: OR = 1.01, 95% CI 0.68-1.50, p = 0.95; measured by MMSE: OR = 0.90, 95% CI 0.59-1.37, p = 0.62). Education modified the effect of pRBD on MCI (measured by MoCA: p < 0.001; measured by MMSE: p = 0.061) and gait speed (p = 0.008). Conclusions: Our findings suggest that pRBD increases the risk of cognitive/motor impairments for a community-dwelling older population, and education could alleviate the negative effects. These findings implicate that education may have beneficial effects on delaying the onset of cognitive/motor decline in pRBD subjects.
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Affiliation(s)
- Meijie Chen
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China
| | - Jie Chen
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China
| | - Xitong Xu
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China
| | - Fangwei Qiao
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China
| | - Xue Wang
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China
| | - Shaozhen Ji
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China.,Clinical Center for Parkinson's Disease, Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhuqin Gu
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China.,Clinical Center for Parkinson's Disease, Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Key Laboratory for Neurodegenerative Disease of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China
| | - Jagadish K Chhetri
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Piu Chan
- Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China.,Clinical Center for Parkinson's Disease, Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Key Laboratory for Neurodegenerative Disease of the Ministry of Education, Beijing Key Laboratory for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China
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35
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Abstract
Stroke is a leading cause of death and disability. It is a complex and largely heterogeneous condition. Prognosis for variations in impairment and recovery following stroke continues to be challenging and inaccurate, highlighting the need to examine the influence of other currently unknown variables to better predict and understand interindividual differences in stroke impairment and recovery. The concept of "cognitive reserve," a feature of brain function said to moderate the relationship between brain pathology and clinical outcomes, might provide a partial explanation. This review discusses the potential significance of cognitive reserve in the context of stroke, with reference to reduced burden of disability poststroke, health promotion, intervention and secondary prevention of cognitive impairment, ease and challenges of translation into clinical practice, prognosis and prediction of recovery, and clinical decisions and trial stratification. Discussions from the review aim to encourage stroke clinicians and researchers to better consider the role of premorbid, lifestyle-related variables, such as cognitive reserve, in facilitating successful neurological outcomes and recovery following stroke.
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Affiliation(s)
- Emily Rosenich
- University of South Australia, Adelaide, South Australia, Australia
| | - Brenton Hordacre
- University of South Australia, Adelaide, South Australia, Australia
| | - Catherine Paquet
- University of South Australia, Adelaide, South Australia, Australia
| | - Simon A Koblar
- University of Adelaide, Adelaide, South Australia, Australia
| | - Susan L Hillier
- University of South Australia, Adelaide, South Australia, Australia
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36
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Robison LS, Francis N, Popescu DL, Anderson ME, Hatfield J, Xu F, Anderson BJ, Van Nostrand WE, Robinson JK. Environmental Enrichment: Disentangling the Influence of Novelty, Social, and Physical Activity on Cerebral Amyloid Angiopathy in a Transgenic Mouse Model. Int J Mol Sci 2020; 21:E843. [PMID: 32012921 PMCID: PMC7038188 DOI: 10.3390/ijms21030843] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 01/23/2020] [Accepted: 01/26/2020] [Indexed: 11/16/2022] Open
Abstract
Cerebral amyloid angiopathy (CAA) is the deposition of amyloid protein in the cerebral vasculature, a common feature in both aging and Alzheimer's disease (AD). However, the effects of environmental factors, particularly cognitive stimulation, social stimulation, and physical activity, on CAA pathology are poorly understood. These factors, delivered in the form of the environmental enrichment (EE) paradigm in rodents, have been shown to have beneficial effects on the brain and behavior in healthy aging and AD models. However, the relative importance of these subcomponents on CAA pathology has not been investigated. Therefore, we assessed the effects of EE, social enrichment (SOC), and cognitive enrichment (COG) compared to a control group that was single housed without enrichment (SIN) from 4 to 8 months of age in wild-type mice (WT) and Tg-SwDI mice, a transgenic mouse model of CAA that exhibits cognitive/behavioral deficits. The results show that individual facets of enrichment can affect an animal model of CAA, though the SOC and combined EE conditions are generally the most effective at producing physiological, cognitive/behavioral, and neuropathological changes, adding to a growing literature supporting the benefits of lifestyle interventions.
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Affiliation(s)
- Lisa S. Robison
- Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794, USA; (L.S.R.); (N.F.); (D.L.P.); (M.E.A.); (B.J.A.)
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, 47 New Scotland Ave, Albany, NY 12208, USA
| | - Nikita Francis
- Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794, USA; (L.S.R.); (N.F.); (D.L.P.); (M.E.A.); (B.J.A.)
- George & Anne Ryan Institute for Neuroscience, 130 Flagg Road, University of Rhode Island, Kingston, RI 02881, USA; (J.H.); (F.X.); (W.E.V.N.)
| | - Dominique L. Popescu
- Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794, USA; (L.S.R.); (N.F.); (D.L.P.); (M.E.A.); (B.J.A.)
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 700 Butler Drive, Providence, RI 02906, USA
| | - Maria E. Anderson
- Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794, USA; (L.S.R.); (N.F.); (D.L.P.); (M.E.A.); (B.J.A.)
- Department of Psychology, Farmingdale State College, 2350 Broadhollow Rd, Farmingdale, NY 11735, USA
| | - Joshua Hatfield
- George & Anne Ryan Institute for Neuroscience, 130 Flagg Road, University of Rhode Island, Kingston, RI 02881, USA; (J.H.); (F.X.); (W.E.V.N.)
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI 02881, USA
| | - Feng Xu
- George & Anne Ryan Institute for Neuroscience, 130 Flagg Road, University of Rhode Island, Kingston, RI 02881, USA; (J.H.); (F.X.); (W.E.V.N.)
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI 02881, USA
| | - Brenda J. Anderson
- Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794, USA; (L.S.R.); (N.F.); (D.L.P.); (M.E.A.); (B.J.A.)
| | - William E. Van Nostrand
- George & Anne Ryan Institute for Neuroscience, 130 Flagg Road, University of Rhode Island, Kingston, RI 02881, USA; (J.H.); (F.X.); (W.E.V.N.)
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI 02881, USA
| | - John K. Robinson
- Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794, USA; (L.S.R.); (N.F.); (D.L.P.); (M.E.A.); (B.J.A.)
- George & Anne Ryan Institute for Neuroscience, 130 Flagg Road, University of Rhode Island, Kingston, RI 02881, USA; (J.H.); (F.X.); (W.E.V.N.)
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, RI 02881, USA
- Department of Psychology, University of Rhode Island, Kingston, RI 02881, USA
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Shoukry S, Elmissiry M, Abulfotooh A, Moussa A, Mahfouz W, Dawood W, Abdel-Karim A, Hassouna M. A prototype non-invasive urodynamic test to estimate voiding reserve in normal adult males. Arab J Urol 2019; 17:251-256. [PMID: 31723441 PMCID: PMC6830265 DOI: 10.1080/2090598x.2019.1649892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/23/2019] [Indexed: 11/13/2022] Open
Abstract
Objective: To propose a prototype non-invasive test to estimate voiding reserve in normal adult men; identifying its feasibility, limitations, and initial results. Subjects and methods: In all, 30 adult healthy male volunteers aged <40 years were included in the study. Initial free uroflowmetry was done with post-void residual urine volume (PVR) assessment using ultrasonography. The men were later asked to void into a uroflowmeter through a condom catheter attached to the glans penis and connected to an outflow tube with specific vertical heights (10, 20, 30, 40, 50 and 60 cm) on different days. The mean maximum urinary flow rate (Qmax) and PVR at each height were compared with the Qmax and PVR at the initial free uroflowmetry. The maximum height at which the Qmax and PVR remained normal was considered the normal voiding reserve for that age group. Results: All the men completed the study without any complications. At zero level, the mean Qmax was 27.6 mL/s, which then dropped gradually to reach 17.8 mL/s at 60 cm, where still 83% of the men had a normal Qmax. The PVR was nil at zero level and started to exceed the normal range at 50 and 60 cm height (58 and 65.7 mL, respectively). So, the maximum height resistance at which the men could have a normal Qmax and normal PVR was 40 cm. Conclusions: The use of the tube height-resistance test to assess voiding reserve is feasible, non-invasive and has no complications. A 40-cm height resistance can be considered a reference level that a young adult male should be tested against to estimate his voiding reserve. Abbreviations: NPV: negative predictive value; PdetQmax: maximum detrusor pressure at maximum urinary flow; PPV: positive predictive value; PVR: post-void residual urine volume; ROC: receiver operating characteristic
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Affiliation(s)
- Shafik Shoukry
- Section of Voiding Dysfunction and Urodynamics, Department of Urology, Alexandria University, Alexandria, Egypt
| | - Mostafa Elmissiry
- Section of Voiding Dysfunction and Urodynamics, Department of Urology, Alexandria University, Alexandria, Egypt
| | - Ahmed Abulfotooh
- Section of Voiding Dysfunction and Urodynamics, Department of Urology, Alexandria University, Alexandria, Egypt
| | - Ahmed Moussa
- Section of Voiding Dysfunction and Urodynamics, Department of Urology, Alexandria University, Alexandria, Egypt
| | - Wally Mahfouz
- Section of Voiding Dysfunction and Urodynamics, Department of Urology, Alexandria University, Alexandria, Egypt
| | - Waleed Dawood
- Section of Voiding Dysfunction and Urodynamics, Department of Urology, Alexandria University, Alexandria, Egypt
| | - Aly Abdel-Karim
- Section of Voiding Dysfunction and Urodynamics, Department of Urology, Alexandria University, Alexandria, Egypt
| | - Mohamed Hassouna
- Section of Voiding Dysfunction and Urodynamics, Department of Urology, Alexandria University, Alexandria, Egypt
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Lee PC, Artaud F, Cormier-Dequaire F, Rascol O, Durif F, Derkinderen P, Marques AR, Bourdain F, Brandel JP, Pico F, Lacomblez L, Bonnet C, Brefel-Courbon C, Ory-Magne F, Grabli D, Klebe S, Mangone G, You H, Mesnage V, Brice A, Vidailhet M, Corvol JC, Elbaz A. Examining the Reserve Hypothesis in Parkinson's Disease: A Longitudinal Study. Mov Disord 2019; 34:1663-1671. [PMID: 31518456 DOI: 10.1002/mds.27854] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 08/13/2019] [Accepted: 08/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whether reserve plays a role in Parkinson's disease (PD) patients has received less attention than in dementia and has been mainly examined in relation with cognitive function. OBJECTIVE To investigate whether reserve plays a role in the severity and progression of motor, cognitive, and nonmotor PD symptoms by examining whether education level (proxy of reserve) is associated with baseline performance and rate of progression. METHODS We used data from a longitudinal cohort of PD patients (≤5-year disease duration at baseline) annually followed up to 5 years (n = 393; 41% women; mean age = 62.3 years, standard deviation = 10.0; mean disease duration = 2.6 years, standard deviation = 1.5). We examined the relationship of education with time to reach Hoehn and Yahr stage ≥3 using Cox regression and with baseline severity and progression of motor (Movement Disorder Society-Unified Parkinson's Disease Rating Scale parts II and III, gait speed), cognitive (Mini-Mental State Examination), and nonmotor (depression, anxiety, nonmotor symptoms scale, quality of life) symptoms using mixed models. RESULTS Education level was not associated with age at onset or diagnosis. Compared with the low-education group, the incidence of Hoehn and Yahr ≥3.0 was 0.42 times lower (95% confidence interval, 0.22-0.82, P = 0.012) in the high-education group. Higher education was associated with better baseline motor function (P < 0.001), but not with the rate of motor decline (P > 0.15). Similar results were observed for cognition. Education was not associated with nonmotor symptoms. CONCLUSIONS Higher education is associated with better baseline motor/cognitive function in PD, but not with rate of decline, and with a lower risk of reaching Hoehn and Yahr ≥3 during the follow-up. Our observations are consistent with a passive reserve hypothesis for motor/cognitive symptoms. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Pei-Chen Lee
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,Preventive Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.,Taipei City Hospital, Taipei, Taiwan
| | - Fanny Artaud
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
| | - Florence Cormier-Dequaire
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Olivier Rascol
- NS-PARK/FCRIN Network, Paris, France.,Universityof Toulouse 3, Centre Hospitalo-Universitaire de Toulouse and INSERM; Centre d'Investigation Clinique CIC1436, Départements de Neurosciences et de Pharmacologie Clinique, NeuroToul COEN center, Toulouse, France
| | - Franck Durif
- NS-PARK/FCRIN Network, Paris, France.,Department of Neurology, Centre Hospitalo-Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Pascal Derkinderen
- NS-PARK/FCRIN Network, Paris, France.,Department of Neurology, Centre Hospitalo-Universitaire de Nantes, Nantes, France
| | - Ana-Raquel Marques
- NS-PARK/FCRIN Network, Paris, France.,Department of Neurology, Centre Hospitalo-Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | | | | | - Fernando Pico
- Department of Neurology, Centre Hospitalier de Versailles; and Université Versailles Saint Quentin en Yvelines et Paris Saclay, Versailles, France
| | - Lucette Lacomblez
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Cecilia Bonnet
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Christine Brefel-Courbon
- NS-PARK/FCRIN Network, Paris, France.,Universityof Toulouse 3, Centre Hospitalo-Universitaire de Toulouse and INSERM; Centre d'Investigation Clinique CIC1436, Départements de Neurosciences et de Pharmacologie Clinique, NeuroToul COEN center, Toulouse, France
| | - Fabienne Ory-Magne
- NS-PARK/FCRIN Network, Paris, France.,Universityof Toulouse 3, Centre Hospitalo-Universitaire de Toulouse and INSERM; Centre d'Investigation Clinique CIC1436, Départements de Neurosciences et de Pharmacologie Clinique, NeuroToul COEN center, Toulouse, France
| | - David Grabli
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Stephan Klebe
- Department of Neurology, University Hospital Essen, Essen, Germany
| | - Graziella Mangone
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Hana You
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Valérie Mesnage
- Department of Neurology, Centre Hospitalo-Universitaire Saint-Antoine, Paris, France
| | - Alexis Brice
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Marie Vidailhet
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Jean-Christophe Corvol
- Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France.,Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France.,NS-PARK/FCRIN Network, Paris, France
| | - Alexis Elbaz
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France
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De Rosa S, Polimeni A, Petraco R, Davies JE, Indolfi C. Diagnostic Performance of the Instantaneous Wave-Free Ratio: Comparison With Fractional Flow Reserve. Circ Cardiovasc Interv 2019; 11:e004613. [PMID: 29326150 DOI: 10.1161/circinterventions.116.004613] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 11/16/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND Aim of the present study was to perform a meta-analysis of all available studies comparing the instantaneous wave-free ratio (iFR) with fractional flow reserve (FFR). METHODS AND RESULTS Published trials comparing the iFR with FFR were searched for in PubMed, Google Scholar, and Scopus electronic databases. A total of 23 studies were available for the analysis, including 6381 stenoses. First, a meta-analysis of all studies was performed exploring the correlation between FFR and iFR. Interestingly, we found good correlation (0.798 [0.78-0.82]) between the 2 indices (P<0.001). In addition, to evaluate the diagnostic performance of iFR to identify FFR-positive coronary stenoses, we performed an additional meta-analysis, summarizing the results of receiver operating characteristics analyses from individual studies reporting the area under the curve. Summing the results of these studies, we found that iFR has a good diagnostic performance for the identification of FFR-positive stenoses (area under the curve=0.88 [0.86-0.90]; P<0.001). Furthermore, our search results included 5 studies that compared iFR and FFR to a third independent reference standard. Interestingly, no significant differences between iFR and FFR were reported in those studies. CONCLUSIONS The present meta-analysis shows that iFR significantly correlates with standard FFR and shows a good diagnostic performance in identifying FFR-positive coronary stenoses. Finally, iFR and FFR have similar diagnostic efficiency for detection of ischemia-inducing stenoses when tested against a third comparator.
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Affiliation(s)
- Salvatore De Rosa
- From the Division of Cardiology, Department of Medical and Surgical Sciences (S.D.R., A.P., C.I.) and URT-CNR of IFC (C.I.), Magna Graecia University, Catanzaro, Italy; and National Heart and Lung Institute, Imperial College London, United Kingdom (R.P., J.E.D.)
| | - Alberto Polimeni
- From the Division of Cardiology, Department of Medical and Surgical Sciences (S.D.R., A.P., C.I.) and URT-CNR of IFC (C.I.), Magna Graecia University, Catanzaro, Italy; and National Heart and Lung Institute, Imperial College London, United Kingdom (R.P., J.E.D.)
| | - Ricardo Petraco
- From the Division of Cardiology, Department of Medical and Surgical Sciences (S.D.R., A.P., C.I.) and URT-CNR of IFC (C.I.), Magna Graecia University, Catanzaro, Italy; and National Heart and Lung Institute, Imperial College London, United Kingdom (R.P., J.E.D.)
| | - Justin E Davies
- From the Division of Cardiology, Department of Medical and Surgical Sciences (S.D.R., A.P., C.I.) and URT-CNR of IFC (C.I.), Magna Graecia University, Catanzaro, Italy; and National Heart and Lung Institute, Imperial College London, United Kingdom (R.P., J.E.D.)
| | - Ciro Indolfi
- From the Division of Cardiology, Department of Medical and Surgical Sciences (S.D.R., A.P., C.I.) and URT-CNR of IFC (C.I.), Magna Graecia University, Catanzaro, Italy; and National Heart and Lung Institute, Imperial College London, United Kingdom (R.P., J.E.D.).
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Vasunilashorn SM, Ngo LH, Jones RN, Inouye SK, Hall KT, Gallagher J, Dillon ST, Xie Z, Libermann TA, Marcantonio ER. The Association Between C-Reactive Protein and Postoperative Delirium Differs by Catechol-O-Methyltransferase Genotype. Am J Geriatr Psychiatry 2019; 27:1-8. [PMID: 30424994 PMCID: PMC6310215 DOI: 10.1016/j.jagp.2018.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/09/2018] [Accepted: 09/10/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Catechol-O-methyltransferase (COMT), a key enzyme in degrading catecholamines associated with the stress response, may influence susceptibility to delirium. Individuals with the COMT (rs4680) Val/Val genotype (designated "warriors") withstand the onset of neuropsychiatric disorders and cognitive decline, whereas individuals with Met/Met and Val/Met genotypes ("nonwarriors") are more susceptible to these conditions. We evaluated whether COMT genotype modifies the established association between acute phase reactant (stress marker) C-reactive protein (CRP) and postoperative delirium. METHODS This was a prospective cohort study conducted at two academic medical centers. The study involved 547 patients aged 70 or older undergoing major noncardiac surgery. We collected blood, extracted DNA, and performed COMT genotyping using allele-specific polymerase chain reaction assays, considering warriors versus nonwarriors. High plasma CRP, measured on postoperative day 2 using enzyme-linked immunosorbent assay, was defined by the highest sample-based quartile (≥234.12 mg/L). Delirium was determined using the Confusion Assessment Method, augmented by a validated chart review. We used generalized linear models adjusted for age, sex, surgery type, and race/ethnicity, stratified by COMT genotype, to determine whether the association between CRP and delirium differed by COMT. RESULTS Prevalence of COMT warriors was 26%, and postoperative delirium occurred in 23%. Among COMT warriors, high CRP was not associated with delirium (relative risk [RR] 1.0, 95% confidence interval [CI] 0.4-2.6). In contrast, among nonwarriors, we found the expected relationship of high CRP and delirium (RR 1.5, 95% CI 1.1-2.2). CONCLUSION COMT warriors may be protected against the increased risk of delirium associated with high CRP on postoperative day 2. With further confirmation, COMT genotype may help target interventions for delirium prevention in the vulnerable nonwarrior group.
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Affiliation(s)
| | - Long H. Ngo
- Beth Israel Deaconess Medical Center,Harvard Medical School
| | - Richard N. Jones
- Brown University Warren Alpert Medical School,Hebrew SeniorLife
| | - Sharon K. Inouye
- Beth Israel Deaconess Medical Center,Harvard Medical School,Hebrew SeniorLife
| | | | | | - Simon T. Dillon
- Beth Israel Deaconess Medical Center,Harvard Medical School
| | - Zhongcong Xie
- Harvard Medical School,Massachusetts General Hospital
| | | | - Edward R. Marcantonio
- Beth Israel Deaconess Medical Center,Harvard Medical School,Brown University Warren Alpert Medical School
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41
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Schram B, Orr R, Rigby T, Pope R. An Analysis of Reported Dangerous Incidents, Exposures, and Near Misses amongst Army Soldiers. Int J Environ Res Public Health 2018; 15:E1605. [PMID: 30060595 PMCID: PMC6121289 DOI: 10.3390/ijerph15081605] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 11/16/2022]
Abstract
Occupational health and safety incidents occurring in the military context are of great concern to personnel and commanders. Incidents such as "dangerous incidents", "exposures", and "near misses" (as distinct from injuries, illnesses, and fatalities) indicate serious health and safety risks faced by military personnel, even if they do not cause immediate harm. These risks may give rise to harm in the future, if not adequately addressed, and in some cases the incidents may cause latent harm. The purpose of this study was to ascertain the rates and patterns of incidents of these types reported by full time (ARA) and part time (ARES) Australian Army personnel. A retrospective cohort study was performed using self-reported incident data from the Workplace Health, Safety, Compensation and Reporting (WHSCAR) database over a two-year period. Data were analysed descriptively. Of 3791 such incidents, 3636 (96 percent) occurred in ARA and 155 (4 percent) in ARES personnel, somewhat consistent with the proportions of total army person-years served in each (ARA 93 percent; ARES 7 percent). In ARA, 84 percent of these incident types were exposures, 14 percent near misses, and 2 percent dangerous incidents. In ARES, 55 percent of incidents were exposures, 38 percent near misses, and 7 percent dangerous incidents. Soldiers at the rank of 'private' experienced the highest rates of these incident types, in both ARA and ARES. Driving gave rise to more near misses than any other activity, in both populations. Exposures to chemicals and sounds were more common in the ARA than ARES. The ARES reported higher proportions of vehicle near misses and multiple mechanism dangerous incidents than the ARA. The findings of this study can usefully inform development of risk mitigation strategies for dangerous incidents, exposures, and near misses in army personnel.
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Affiliation(s)
- Ben Schram
- Tactical Research Unit, Bond University, Robina, QLD 4226, Australia.
| | - Robin Orr
- Tactical Research Unit, Bond University, Robina, QLD 4226, Australia.
| | - Timothy Rigby
- Faculty of Health Science and Medicine, Bond University, Gold Coast, QLD 4226, Australia.
| | - Rodney Pope
- Tactical Research Unit, Bond University, Robina, QLD 4226, Australia.
- School of Community Health, Charles Sturt University, Albury-Wodonga, NSW 2640, Australia.
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Schwartz CE, Zhang J, Michael W, Eton DT, Rapkin BD. Reserve-building activities attenuate treatment burden in chronic illness: The mediating role of appraisal and social support. Health Psychol Open 2018; 5:2055102918773440. [PMID: 29785278 PMCID: PMC5954584 DOI: 10.1177/2055102918773440] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
This study examines the importance of four psychosocial factors—personality,
cognitive appraisal of quality of life, social support, and current
reserve-building—in predicting treatment burden in chronically ill patients.
Chronically ill patients (n = 446) completed web-based
measures. Structural equation modeling was used to investigate psychosocial
factors predicting treatment burden. Reserve-building activities indirectly
reduced treatment burden by: (1) reducing health worries appraisals, (2)
reducing financial difficulties, (3) increasing calm and peaceful appraisals,
and (4) increasing perceived social support. These findings point to key
behaviors that chronically ill people can use to attenuate their treatment
burden.
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Affiliation(s)
- Carolyn E Schwartz
- DeltaQuest Foundation, Inc., USA.,Tufts University School of Medicine, USA
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Richmond CA, Rickner H, Shah MS, Ediger T, Deary L, Zhou F, Tovaglieri A, Carlone DL, Breault DT. JAK/STAT-1 Signaling Is Required for Reserve Intestinal Stem Cell Activation during Intestinal Regeneration Following Acute Inflammation. Stem Cell Reports 2018; 10:17-26. [PMID: 29276155 DOI: 10.1016/j.stemcr.2017.11.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 11/16/2017] [Accepted: 11/17/2017] [Indexed: 01/26/2023] Open
Abstract
The intestinal epithelium serves as an essential barrier to the outside world and is maintained by functionally distinct populations of rapidly cycling intestinal stem cells (CBC ISCs) and slowly cycling, reserve ISCs (r-ISCs). Because disruptions in the epithelial barrier can result from pathological activation of the immune system, we sought to investigate the impact of inflammation on ISC behavior during the regenerative response. In a murine model of αCD3 antibody-induced small-intestinal inflammation, r-ISCs proved highly resistant to injury, while CBC ISCs underwent apoptosis. Moreover, r-ISCs were induced to proliferate and functionally contribute to intestinal regeneration. Further analysis revealed that the inflammatory cytokines interferon gamma and tumor necrosis factor alpha led to r-ISC activation in enteroid culture, which could be blocked by the JAK/STAT inhibitor, tofacitinib. These results highlight an important role for r-ISCs in response to acute intestinal inflammation and show that JAK/STAT-1 signaling is required for the r-ISC regenerative response.
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Cizginer S, Marcantonio E, Vasunilashorn S, Pascual-Leone A, Shafi M, Schmitt EM, Inouye SK, Jones RN. The Cognitive Reserve Model in the Development of Delirium: The Successful Aging After Elective Surgery Study. J Geriatr Psychiatry Neurol 2017; 30:337-345. [PMID: 29061098 PMCID: PMC5663189 DOI: 10.1177/0891988717732152] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We evaluated the role of cognitive and brain reserve markers in modifying the risk of postoperative delirium associated with a pathophysiologic marker. The Successful Aging after Elective Surgery study (SAGES) enrolled 556 adults age ≥70 years without dementia scheduled for major surgery. Patients were assessed preoperatively and daily during hospitalization for delirium. We used C-reactive protein (CRP) as a pathophysiologic marker of inflammation, previously associated with delirium. Markers of reserve included vocabulary knowledge, education, cognitive activities, occupation type and complexity, head circumference, intracranial volume, and leisure activities. Vocabulary knowledge, cognitive activities, and education significantly modified the association of CRP and postoperative delirium ( P < .01). However, effect sizes-when statistically significant-were small in magnitude. The strongest effect modification was observed for vocabulary knowledge: high scores were generally protective but not at high levels of CRP. Select reserve markers attenuate the risk of delirium associated with lower grade inflammatory processes, supporting the role of reserve in delirium.
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Affiliation(s)
- Sevdenur Cizginer
- Brown University, Warren Alpert Medical School, Providence, Rhode Island
| | | | | | | | - Mouhsin Shafi
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA
| | - Eva M. Schmitt
- Institute for Aging Research, Hebrew SeniorLife, Boston MA
| | - Sharon K. Inouye
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston MA,Institute for Aging Research, Hebrew SeniorLife, Boston MA
| | - Richard N. Jones
- Brown University, Warren Alpert Medical School, Providence, Rhode Island
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Griesbach GS, Masel BE, Helvie RE, Ashley MJ. The Impact of Traumatic Brain Injury on Later Life: Effects on Normal Aging and Neurodegenerative Diseases. J Neurotrauma 2017; 35:17-24. [PMID: 28920532 DOI: 10.1089/neu.2017.5103] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The acute and chronic effects of traumatic brain injury (TBI) have been widely described; however, there is limited knowledge on how a TBI sustained during early adulthood or mid-adulthood will influence aging. Epidemiological studies have explored whether TBI poses a risk for dementia and other neurodegenerative diseases associated with aging. We will discuss the influence of TBI and resulting medical comorbidities such as endocrine, sleep, and inflammatory disturbances on age-related gray and white matter changes and cognitive decline. Post mortem studies examining amyloid, tau, and other proteins will be discussed within the context of neurodegenerative diseases and chronic traumatic encephalopathy. The data support the suggestion that pathological changes triggered by an earlier TBI will have an influence on normal aging processes and will interact with neurodegenerative disease processes rather than the development of a specific disease, such as Alzheimer's or Parkinson's. Chronic neurophysiologic change after TBI may have detrimental effects on neurodegenerative disease.
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Affiliation(s)
- Grace S Griesbach
- 1 Centre for Neuro Skills Clinical Research and Education Foundation , Bakersfield, California.,2 Department of Neurosurgery, David Geffen School of Medicine at the University of California , Los Angeles, California
| | - Brent E Masel
- 1 Centre for Neuro Skills Clinical Research and Education Foundation , Bakersfield, California.,3 University of Texas Medical Branch , Galveston, Texas
| | - Richard E Helvie
- 1 Centre for Neuro Skills Clinical Research and Education Foundation , Bakersfield, California
| | - Mark J Ashley
- 1 Centre for Neuro Skills Clinical Research and Education Foundation , Bakersfield, California
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Yu L, Boyle PA, Segawa E, Leurgans S, Schneider JA, Wilson RS, Bennett DA. Residual decline in cognition after adjustment for common neuropathologic conditions. Neuropsychology 2015; 29:335-43. [PMID: 25495832 PMCID: PMC4420708 DOI: 10.1037/neu0000159] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Neurodegenerative and cerebrovascular conditions are common in old age and are associated with cognitive decline. However, considerable heterogeneity remains in residual decline (i.e., person-specific trajectories of cognitive decline adjusted for these common neuropathologic conditions). The present study aimed to characterize profiles of residual decline in late life cognition. METHOD Up to 19 waves of longitudinal cognitive data were collected from 876 autopsied participants from 2 ongoing clinical-pathologic cohort studies of aging. Uniform neuropathologic examinations quantified measures of Alzheimer's disease, cerebral infarcts, Lewy body disease, and hippocampal sclerosis. Random effects mixture models characterized latent profiles of residual decline in global cognition. RESULTS We identified 4 latent groups, and each group demonstrated distinct residual decline profiles. On average, 44% of the participants had little or no decline, 35% showed moderate decline, 13% showed severe decline and the rest (8%) had substantial within-subject fluctuation of longitudinal cognitive measures. These latent groups differed in psychological, experiential and neurobiologic factors that have been previously shown to be associated with cognitive decline. Specifically, compared with nondecliners, decliners had more depressive symptoms, were more socially isolated; were less engaged in cognitive or physical activities; and had lower density of noradrenergic neurons in locus ceruleus. CONCLUSIONS After controlling for common dementia related pathologies, considerable residual variability remains in cognitive aging trajectories and this variability is not random but rather is related to markers of cognitive and neural reserve. The mixture modeling approach provides a powerful tool to identify latent groups with distinct cognitive trajectories.
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Affiliation(s)
- Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical
Center, Chicago, IL
- Department of Neurological Sciences, Rush University Medical Center,
Chicago, IL
| | - Patricia A. Boyle
- Rush Alzheimer's Disease Center, Rush University Medical
Center, Chicago, IL
- Department of Behavioral Sciences, Rush University Medical Center,
Chicago, IL
| | - Eisuke Segawa
- Department of Medical Social Sciences, Feinberg School of Medicine,
Northwestern University, Chicago, IL
| | - Sue Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical
Center, Chicago, IL
- Department of Neurological Sciences, Rush University Medical Center,
Chicago, IL
- Department of Preventive Medicine, Rush University Medical Center,
Chicago, IL
| | - Julie A. Schneider
- Rush Alzheimer's Disease Center, Rush University Medical
Center, Chicago, IL
- Department of Neurological Sciences, Rush University Medical Center,
Chicago, IL
- Department of Pathology, Rush University Medical Center, Chicago,
IL
| | - Robert S. Wilson
- Rush Alzheimer's Disease Center, Rush University Medical
Center, Chicago, IL
- Department of Neurological Sciences, Rush University Medical Center,
Chicago, IL
- Department of Behavioral Sciences, Rush University Medical Center,
Chicago, IL
| | - David A. Bennett
- Rush Alzheimer's Disease Center, Rush University Medical
Center, Chicago, IL
- Department of Neurological Sciences, Rush University Medical Center,
Chicago, IL
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Hays GC, Mortimer JA, Ierodiaconou D, Esteban N. Use of long-distance migration patterns of an endangered species to inform conservation planning for the world's largest marine protected area. Conserv Biol 2014; 28:1636-1644. [PMID: 25039538 DOI: 10.1111/cobi.12325] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 02/26/2014] [Indexed: 06/03/2023]
Abstract
Large marine protected areas (MPAs), each hundreds of thousands of square kilometers, have been set up by governments around the world over the last decade as part of efforts to reduce ocean biodiversity declines, yet their efficacy is hotly debated. The Chagos Archipelago MPA (640,000 km(2) ) (Indian Ocean) lies at the heart of this debate. We conducted the first satellite tracking of a migratory species, the green turtle (Chelonia mydas), within the MPA and assessed the species' use of protected versus unprotected areas. We developed an approach to estimate length of residence within the MPA that may have utility across migratory taxa including tuna and sharks. We recorded the longest ever published migration for an adult cheloniid turtle (3979 km). Seven of 8 tracked individuals migrated to distant foraging grounds, often ≥1000 km outside the MPA. One turtle traveled to foraging grounds within the MPA. Thus, networks of small MPAs, developed synergistically with larger MPAs, may increase the amount of time migrating species spend within protected areas. The MPA will protect turtles during the breeding season and will protect some turtles on their foraging grounds within the MPA and others during the first part of their long-distance postbreeding oceanic migrations. International cooperation will be needed to develop the network of small MPAs needed to supplement the Chagos Archipelago MPA.
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Affiliation(s)
- Graeme C Hays
- Centre for Integrative Ecology, School of Life and Environmental Sciences, Deakin University, Warrnambool, Vic., 3280, Australia; Department of Biosciences, Swansea University, Singleton Park, Swansea, SA2, 8PP, United Kingdom
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Sasi V, Nemes A, Forster T, Ungi I. Functional assessment of a left coronary-pulmonary artery fistula by coronary flow reserve. Postepy Kardiol Interwencyjnej. 2014;10:141-143. [PMID: 25061466 PMCID: PMC4108744 DOI: 10.5114/pwki.2014.43526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 04/15/2014] [Accepted: 05/08/2014] [Indexed: 12/25/2022] Open
Abstract
We report a 71-year-old man who presented with atypical chest pain. Coronary angiography did not reveal left main or proximal left anterior descending coronary artery stenosis, but a fistulous communication with a stronger tube-like fistula was present originating from the proximal left anterior descending coronary artery and emptying into the main pulmonary artery. Fractional flow reserve and coronary flow reserve measurements were performed to gain more data on the potential functional aspects of this fistula. With the present case, the importance of functional evaluation of these fistulas is demonstrated.
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Abstract
Many conservation organizations use spatial prioritization to help identify locations in which to work. Increasingly, prioritizations seek to account for spatial heterogeneity in the costs of conservation, motivated in part by claims of large efficiency savings when these costs are included. I critically review the cost estimates on which such claims are based, focusing on acquisition and management costs associated with terrestrial protected areas. If researchers are to evaluate how including costs affects conservation planning outcomes, estimation methods need to preserve the covariation between and relative variation within costs and benefits of conservation activities. However, widely used methods for estimating costs and incorporating them into prioritizations may not meet these standards. For example, among relevant studies, there is surprisingly little attention given to the costs that conservation organizations actually face. Instead, there is a heavy reliance on untested proxies for conservation costs. Analytical shortcuts are also common. Now that debate is moving beyond whether to account for costs in conservation planning, it is time to evaluate just how we can include them to greatest effect.
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Affiliation(s)
- Paul R Armsworth
- Department of Ecology and Evolutionary Biology, University of Tennessee, Knoxville, Tennessee
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Eskelinen M, Ollonen P. Contribution of emotional distance and reserve in patient-physician communication in healthy study patients, and in patients with benign breast disease and breast cancer: a prospective case-control study in Finland. Anticancer Res 2014; 34:1269-1274. [PMID: 24596371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Emotionally-restricted and 'poor-understanding'communication between a patient and their physician may be associated with difficulties in diagnosis and with poor treatment results in clinical practice. To our knowledge, the associations between distance and reserve in patient-physician communication and the risk of breast cancer (BC) are rarely considered together in a prospective study. PATIENTS AND METHODS In an extension of the Kuopio Breast Cancer Study, 115 women with breast symptoms were evaluated for emotional distance and reservation in patient-physician communication before any diagnostic procedures were carried out. RESULTS Clinical examination and biopsy showed BC in 34 patients, benign breast disease (BBD) in 53 patients, while 28 individuals were shown to be healthy (HSS). There was a trend for the BC group to report more emotional distance in patient-physician communication (30/34, 89.0%; grade I to IV emotional distance) than the patients in the HSS and BBD groups (78.6% and 75.5%, grade I to IV emotional distance, respectively). However, the mean of the distance score for HSS, BBD and BC groups differed only slightly in grade II and grade III. The BC group had a higher ERS emotional reservation score in contact (25/34, 73.5%; grade I to IV reserve) than the patients in the HSS and BBD groups (57.1% and 62.1%, grade I to IV reserve, respectively). However, the mean of the reserve score for HSS, BBD and BC groups differed only slightly in grade II, grade III and grade IV. CONCLUSION The results of this study showed that patients with BC could be at risk for emotional distance and reserve in patient-physician communication and this should be taken into account in the relationship between the patient and their physician and may have clinical relevance in day-to-day clinical work.
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Affiliation(s)
- Matti Eskelinen
- Department of Surgery, Kuopio University Hospital, PL 1777, 70211 Kuopio, Finland.
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