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Nevin Manimala Statistics

Amyloid and tau-PET in early-onset AD: Baseline data from the Longitudinal Early-onset Alzheimer’s Disease Study (LEADS)

Alzheimers Dement. 2023 Sep 10. doi: 10.1002/alz.13453. Online ahead of print.

ABSTRACT

INTRODUCTION: We aimed to describe baseline amyloid-beta (Aβ) and tau-positron emission tomograrphy (PET) from Longitudinal Early-onset Alzheimer’s Disease Study (LEADS), a prospective multi-site observational study of sporadic early-onset Alzheimer’s disease (EOAD).

METHODS: We analyzed baseline [18F]Florbetaben (Aβ) and [18F]Flortaucipir (tau)-PET from cognitively impaired participants with a clinical diagnosis of mild cognitive impairment (MCI) or AD dementia aged < 65 years. Florbetaben scans were used to distinguish cognitively impaired participants with EOAD (Aβ+) from EOnonAD (Aβ-) based on the combination of visual read by expert reader and image quantification.

RESULTS: 243/321 (75.7%) of participants were assigned to the EOAD group based on amyloid-PET; 231 (95.1%) of them were tau-PET positive (A+T+). Tau-PET signal was elevated across cortical regions with a parietal-predominant pattern, and higher burden was observed in younger and female EOAD participants.

DISCUSSION: LEADS data emphasizes the importance of biomarkers to enhance diagnostic accuracy in EOAD. The advanced tau-PET binding at baseline might have implications for therapeutic strategies in patients with EOAD.

HIGHLIGHTS: 72% of patients with clinical EOAD were positive on both amyloid- and tau-PET. Amyloid-positive patients with EOAD had high tau-PET signal across cortical regions. In EOAD, tau-PET mediated the relationship between amyloid-PET and MMSE. Among EOAD patients, younger onset and female sex were associated with higher tau-PET.

PMID:37690109 | DOI:10.1002/alz.13453

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The measurement of the left ventricle ejection fraction by a bedside FoCUS examination

Intern Emerg Med. 2023 Sep 10. doi: 10.1007/s11739-023-03414-5. Online ahead of print.

ABSTRACT

The use of point-of-care ultrasound is rapidly increasing in medical practice. This study aims to evaluate the left ventricle systolic function by the bedside focus cardiac ultrasound (FoCUS). We consecutively enrolled n.59 patients of the Emergency Medicine Unit of S. Andrea Hospital. Every patient received a bedside FoCUS examination to estimate the left ventricle (LV) ejection fraction (EF); the LV EF measurements were compared with those obtained by standard echocardiography (as gold standard). The LV EF obtained by the bedside FoCUS examination and the standard echocardiography, resulted, respectively: 50.2 ± 15.1% (by the Quinones equation), 39.5 + 12.0% (by the Lvivo app) and 53.7 + 11.1% (by the standard echocardiography). The correlations between the bedside FoCUS EF measurements versus standard echocardiography were statistically significant: r = + 0.694 p < 1.9 × 10-6 (Quinones equation, Bland-Altman analysis mean = – 2.3%) and r = + 0.571 p < 0.01 (Lvivo app, Bland-Altman analysis mean = – 13.3%). In conclusion, the present study showed a high accuracy of the bedside FoCUS EF evaluations, which may support the diagnosis of the heart failure in an emergency setting without delaying. The EF measurements by the operational method are more precise than those obtained by the unselected images of the software application.

PMID:37690107 | DOI:10.1007/s11739-023-03414-5

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Characterization of chemoresistant human non-small cell lung cancer cells by metabolic and lipidomic profiling

Metabolomics. 2023 Sep 10;19(9):80. doi: 10.1007/s11306-023-02045-3.

ABSTRACT

INTRODUCTION: Lung cancer is one of the most malignant cancers and the leading cause of cancer-related deaths worldwide, while acquired chemoresistance would represent a major problem in the treatment of non-small cell lung cancer (NSCLC) because of the reduced treatment effect and increased rates of recurrence.

METHODS: To establish the chemoresistant NSCLC cells, doxorubicin was treated to A549 cells over 3 months at gradually increasing concentrations from 0.03 to 0.5 µM. Real-time PCR and Western blotting were employed for investigating mRNA and protein expression of the glutathione peroxidase (GPX) protein family and multidrug resistance protein 1 (MRP1) in A549 and A549/CR cells. We also employed gas chromatography mass-spectrometry and nano electrospray ionization mass-spectrometry coupled with multivariate statistical analysis to characterize the unique metabolic and lipidomic profiles of chemoresistant NSCLC cells in order to identify potential therapeutic targets.

RESULTS: Reactive oxygen species levels were decreased, and mRNA and protein levels of GPX2 and multidrug resistance protein 1 (MRP1) were increased in A549/CR. We identified 87 metabolites and intact lipid species in A549 and A549/CR. Among these metabolites, lactic acid, glutamic acid, glycine, proline, aspartic acid, succinic acid, and ceramide, alongside the PC to PE ratio, and arachidonic acid-containing phospholipids were suggested as characteristic features of chemoresistant NSCLC cells (A549/CR).

CONCLUSIONS: This study reveals characteristic feature differences between drug-resistance NSCLC cells and their parental cells. We suggest potential therapeutic targets in chemoresistant NSCLC. Our results provide new insight into metabolic and lipidomic alterations in chemoresistant NSCLC. This could be used as fundamental information to develop therapeutic strategies for the treatment of chemoresistant NSCLC patients.

PMID:37690093 | DOI:10.1007/s11306-023-02045-3

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What is the role of robotic surgery in ovarian cystectomy with fertility preservation?

J Robot Surg. 2023 Sep 10. doi: 10.1007/s11701-023-01704-w. Online ahead of print.

ABSTRACT

To investigate the role of robotic single-site (RSS) ovarian cystectomy in fertility preservation, which was compared with single-port laparoscopic (SPL) surgery based on AMH changes. We retrospectively analyzed medical records of total 156 patients who underwent SPL (n = 72) or RSS (n = 84) surgery with the da Vinci® Si or Xi system. The pre/post-operative AMH levels and total diameter of ovarian cysts were measured. In addition to the surgical method, AMH changes were compared according to the laterality, multiplicity, and pathology of ovarian cysts. A comparison of the characteristics of the SPL group and RSS group, revealed that there were no significant differences in the average age, the diameter of the ovarian cyst, and the number of locule. There were also no statistical differences between the pre-operative and post-operative AMH levels and the average surgical time including the docking time in robotic surgery. A comparison based on the surgical methods, revealed that the decrease in post-operative AMH was lower in the RSS group (24.2 ± 35.9%) than in the SPL group (34.9 ± 29.1%) significantly (p = 0.044). In patients with endometriosis, the decrease in AMH was greater, than that in patients without endometriosis. A longer operation time, larger ovarian cysts and multi-locular cysts were associated with lower AMH level in both the SPL and RSS groups (Pearson correlation coefficient: – 0.320, p = 0.0001, – 0.218, p = 0.007, – 0.236, p = 0.003, respectively). RSS ovarian cystectomy could be a promising new therapeutic option for fertility preservation in complex cases to avoid an additional side port.

PMID:37690086 | DOI:10.1007/s11701-023-01704-w

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Psychosocial Outcomes in Autistic Children Before and During the COVID-19 Pandemic

J Autism Dev Disord. 2023 Sep 10. doi: 10.1007/s10803-023-06101-8. Online ahead of print.

ABSTRACT

Studies on the impact of the COVID-19 pandemic on autistic children’s psychosocial outcomes have shown mixed results. In the current study we aimed to gain a better insight into the effect of the COVID-19 pandemic by comparing psychosocial outcomes collected pre-pandemic with data collected during the pandemic. We used the Strengths and Difficulties Questionnaire (SDQ) to examine change over time in psychosocial outcomes of autistic children from pre-pandemic (T0) to lockdown I (T1) and lockdown II (T2) in the Netherlands. We expected a deterioration in psychosocial outcomes. There were 224 participants in T0 and T1, of which 141 also participated in T2. The results showed a surprising improvement in psychosocial outcomes from T0 to T1. Special education and female gender were associated with increased difficulties over time, while higher age was associated with decreased difficulties. At the subdomain level we found that emotional problems remained stable, while hyperactivity, conduct problems, and peer problems decreased, and prosocial behavior increased. Attending special education predicted increased peer problems over time, while higher age predicted both decreased conduct problems and increased prosocial behavior over time. The COVID-19 pandemic may have temporarily improved the fit between the psychosocial needs and the environment for children with autism in the Netherlands.

PMID:37690082 | DOI:10.1007/s10803-023-06101-8

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Comparison of spatiotemporal burial and contamination of heavy metals in core sediments of two plateau lakes with contrasting environments: implication for anthropogenic-driven processes

Environ Monit Assess. 2023 Sep 10;195(10):1178. doi: 10.1007/s10661-023-11764-y.

ABSTRACT

Investigating the impacts of climatic factors and human activities on sedimentary records of heavy metal (HM) contamination in lakes is essential for decision-making in global environmental monitoring and assessment. Spatiotemporal distributions of grain size (GS) and HM (Al, Cr, Mn, Ni, Cu, Zn, As, and Pb) concentrations have been conducted in core sediments that are collected from two adjacent plateau fault-bound lakes in southwest China with contrasting environments, i.e., deep oligotrophic Lake Fuxian (FX) and shallow hypertrophic Lake Xingyun (XY). Results showed that the average value of d50 in FX (4.61 μm) was lower than that in XY (8.35 μm), but the average concentrations of HMs (except Cr and Mn) in XY were higher than those in FX. Heavy metal burial rates (HMBR) were mainly controlled by sediment accumulation rates (SARs) rather than HM concentrations. The correlation coefficients between GS and HM concentrations became strong as the increasing water depths were associated with a stable sedimentary environment. Time-integrated enrichment factors (EF) and source identification of HMs between FX and XY represented that Cr, Ni, and Cu originated from natural sources but Mn, Zn, As, and Pb from anthropogenic sources, respectively. Regardless of FX and XY, the transition times of HMs from natural to anthropogenic sources occurred in the mid-1960s. Comparison of qualification impacts of climatic factors and human-induced factors on increased anthropogenic HMBR by the partial least squares path modeling (PLS-PM) implied that socio-economic activities, such as population density (PD) and gross domestic product (GDP), provided higher contributors to increased anthropogenic HMBR in XY (0.23/0.71) than FX (0.11/0.18). The comparative results of this study provided new insights into environmental monitoring and management of HM contamination for adjacent lakes with contrasting environments.

PMID:37690077 | DOI:10.1007/s10661-023-11764-y

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The use of videos for diabetes patient education: A systematic review

Diabetes Metab Res Rev. 2023 Sep 10:e3722. doi: 10.1002/dmrr.3722. Online ahead of print.

ABSTRACT

Diabetes prevalence is rising worldwide, calling for public health concerns and interventions to improve prevention and management. Self-care is an important component in reducing the incidence of complications from diabetes, but it must be taught. This systematic review aims to synthesise the evidence for education videos for people with diabetes. Electronic databases, including Ovid (Medline, Embase, EmCare), PsychInfo, CINAHL, Web of Science and Scopus, were searched for studies on educational videos for patients with diabetes that met the inclusion criteria. A total of 36 studies met the inclusion criteria. Data extracted were synthesised through narrative synthesis. Studies examined outcomes including biological (i.e., glycated haemoglobin (HbA1C), weight, BMI), non-biological (health literacy, self-efficacy) and subjective feedback (i.e., acceptability, cultural appropriateness). The most common length of video was ≤10 min. Online dissemination was the most common method of video distribution. A statistically significant decrease (ranging from -0.1% to -2.1%) in HbA1C was noted in 7 of 12 studies examining this outcome. Other studies also found evidence of improvement in health literacy, self-efficacy, physical activity, medication adherence and other outcomes. Feedback from participants was generally positive, and emphasis was placed on the need for cultural appropriateness and representation in the educational videos.

PMID:37690072 | DOI:10.1002/dmrr.3722

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Endoscopic balloon dilation of primary obstructive megaureter: is fluoroscopic guidance necessary?

World J Urol. 2023 Sep 10. doi: 10.1007/s00345-023-04572-z. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the long-term effectiveness, complications, and outcomes of primary obstructive megaureter (POM) treated by endoscopic balloon dilation under fluoroscopic guidance versus not using radioscopy during the procedure.

PATIENTS AND METHODS: A comparative study between POM cases treated at our institution by endoscopic balloon dilation (EBD) under fluoroscopic guidance (FG) (n = 43) vs no fluoroscopic guidance (NFG) (n = 48) between the years 2004 and 2018 was conducted. The procedure in FG consisted of performing a retrograde pyelography before dilation. Then, a guidewire is introduced to the renal pelvis, and the dilation of the vesicoureteral junction is performed using high-pressure balloon catheters under fluoroscopic vision. Finally, a double-J stent is placed between the renal pelvis and bladder. The procedure in NFG was performed exclusively under cystoscopic vision without radiological exposure. Complications, outcomes, and success rates were analyzed using Spearman’s correlation test. Mean follow-up was 12.5 ± 2.2 years in FG and 6.4 ± 1.3 years in NFG.

RESULTS: MAG-3 showed significant differences in renal drainage before and after endoscopic treatment in both groups (p < 0.001 T-test). Statistical analysis did not reveal differences between groups in initial technical failure (r: – 0.035, p = 0.74), early postoperative complications (r: – 0.029, p = 0.79), secondary VUR (r: 0.033, p = 0.76), re-stenosis (r: 0.022, p = 0.84), long-term ureteral reimplantation (r: 0.065, p = 0.55), and final outcome (r: – 0.054, p = 0.61). The endoscopic approach of POM had a long-term success rate of 86.5% in FG VS 89.6% in NFG.

CONCLUSIONS: Endoscopic balloon dilation of POM can be done with no radiation exposure with similar results, effectiveness, and outcomes.

PMID:37690062 | DOI:10.1007/s00345-023-04572-z

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Comparative effects of various running exercise modalities on femoral bone quality in rats

Eur J Appl Physiol. 2023 Sep 10. doi: 10.1007/s00421-023-05293-2. Online ahead of print.

ABSTRACT

BACKGROUND: It is now well established that physical exercise is an effective preventive method to reduce and treat certain chronic diseases, particularly musculoskeletal disorders. At the bone level, running exercise is well known for its positive effects on various parameters of bone quality. There is, however, no consensus regarding the effects of different running exercise modalities on bone quality.

AIM: The objective of this study was to compare the effects of three treadmill running modalities: intermittent, moderate continuous, and a combination of both-on bone quality parameters in rats.

METHODS: Thirty-nine, 5-week-old, male Wistar rats were randomly divided in 4 groups: sedentary control (SED; n = 10), intermittent running exercise (IE; n = 10), continuous running exercise (CE; n = 10) and combined running exercise (COME; n = 9). Rats in running groups were exercised 45 min/day, 5 days/week, for 8 consecutive weeks. Femoral micro-architectural parameters were assessed by micro-CT; femoral osteocyte apoptosis, osteoclast resorption and bone histomorphometry were assessed by histology.

RESULTS: Femoral trabecular thickness in the combined running group was increased (p < 0.0001) compared to respective results in the other running groups (0.13 mm vs 0.11 mm). The cortical thickness, osteocyte lacunae occupancy rate in the whole femur, numbers of apoptotic osteocytes and osteoclastic resorption surfaces were not significantly different between groups. Statistical differences were occasionally noted depending on the femoral anatomical region.

CONCLUSION: These results suggest that the femur should not be considered as the better bone to study the effects of running protocols.

PMID:37690048 | DOI:10.1007/s00421-023-05293-2

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Total Replacement of the First Metatarsophalangeal Joint by Medin PH-Flex and Its Effect on Forefoot Biomechanics in the Propulsion Phase of the Gait Cycle

Acta Chir Orthop Traumatol Cech. 2023;90(4):251-258.

ABSTRACT

PURPOSE OF THE STUDY Total arthroplasty of the first metatarsophalangeal joint is one of the surgical treatment options for patients with advanced hallux rigidus. This study evaluates the pressure changes in the propulsion phase of the gait cycle using dynamic pedobarography after the total arthroplasty of the first metatarsophalangeal joint by Medin PH-Flex and their comparison with the control groups of patients with hallux rigidus and with asymptomatic patients. MATERIAL AND METHODS Dynamic pedobarograph was used to evaluate 15 first MTP joint replacements by Medin PH-Flex implants in 12 female patients, the average time since joint replacement was 3.5 years (1.5 to 5.5 years). The control group consisted of 13 forefeet in 12 patients with hallux rigidus of Grade 3 and Grade 4 according to the Coughlin classification and 17 healthy patients with no clear foot deformity, i.e. of a total of 34 forefeet. A zone for each metatarsal (M1-M5) and the big toe area (T1) were defined with the use of an integrated software. The difference between the pressure under the big toe area and the first metatarsal bone – hallux stiffness (T1-M1) and the forefoot balance parameter, i.e. the difference between the pressures under the medial and lateral half of the forefoot ((M1+M2)-(M3+M4+M5)), was obtained. The parameters were evaluated for each group during the propulsion phase of the gait, i.e. from 55% to 100% of the stance phase and from 75% to 100% of the stance phase, i.e. that part of propulsion when the greatest pressure is exerted on the big toe. RESULTS For the HS parameter (T1-M1) in 55% to 100% of the stance phase, the median value was -0.66 ± 1.22 (-1.90 to 1.45) in the control group, -0.85 ± 1.94 (-1.40 to 3.80) in patients with hallux rigidus, and -0.10 ± 1.48 (-1.30 to 2.40) in patients after the first MTP joint replacement. The median forefoot balance parameter from 55% of the stance phase was -3.48 ± 2.45 (-6.90 to 0.68) in healthy patients and -4.43 ± 2.72 (-6.98 to 0.23) in hallux rigidus patients. In patients after the joint replacement, the value was -3.00 ± 2.46 (-6.20 to 0.40). The data were statistically analysed by the Dunnett’s and Tukey’s multiple comparison tests. The hallux stiffness parameter showed a significant improvement after the joint replacement compared to patients with hallux rigidus (p<0.0001). No statistical significance was confirmed when comparing the joint replacement cases and the healthy patients from the control group (p=0.0007 and p=0.0010, respectively). As concerns the forefoot balance parameter, a significant difference was reported in patients with joint replacement compared to healthy patients from the control group and patients with hallux rigidus (p <0.0001). DISCUSSION The published pedobarographic studies differ in terms of the methodology used, the patient population and the parameters examined. The pedobarographic studies after the replacement of the first MTP joint or after its arthrodesis present inconclusive outcomes. According to the available literature, the joint replacement has the potential to improve mediolateral forefoot loading and to partially restore the weight-bearing function of the first ray. Our analysis of the HS parameter suggests that the MTP joint replacement can improve the big toe function compared to patients with hallux rigidus but fails to achieve the functional outcomes of healthy patients. When evaluating the forefoot balance (FB) parameter, we can observe less loading on the lateral half of the forefoot in the propulsion phase compared to hallux rigidus. Nonetheless, the joint replacement is unable to restore the physiological loading of the foot. CONCLUSIONS The first MTP joint replacement has the potential to improve forefoot function and to bring it closer to that of a healthy person, even though achieving physiological loading of the forefoot is unrealistic. Additional studies will be needed to confirm that the indication for the first MTP joint replacement is justified in hallux rigidus in terms of the effect on forefoot biomechanics. Key words: hallux rigidus, total replacement of the first MTP joint, dynamic pedobarography, footscan.

PMID:37690038