Long‐Term Cognitive Outcome in Anti–N‐Methyl‐D‐Aspartate Receptor Encephalitis

Objective: Cognitive dysfunction is a core symptom of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, but detailed studies on prevalence, characteristics of cognitive deficits, and the potential for recovery are missing. Here, we performed a prospective longitudinal study to assess cognitive long-term outcome and identify clinical predictors. Methods: Standardized comprehensive neuropsychological assessments were performed in 43 patients with NMDAR encephalitis 2.3 years and 4.9 years (median) after disease onset. Cognitive assessments covered executive function, working memory, verbal/visual episodic memory, attention, subjective complaints, and depression and anxiety levels. Cognitive performance of patients was compared to that of 30 healthy participants matched for age, sex, and education. Results: All patients had persistent cognitive deficits 2.3 years after onset, with moderate or severe impairment in >80% of patients. Core deficits included memory and executive function. After 4.9 years, significant improvement of cognitive function was observed, but moderate to severe deficits persisted in two thirds of patients, despite favorable functional neurological outcomes (median modified Rankin Scale = 1). Delayed treatment, higher disease severity, and longer duration of the acute phase were predictors for impaired cognitive outcome. The recovery process was time dependent, with greater gains earlier after the acute phase, although improvements were possible for several years after disease onset. Interpretation: Cognitive deficits are the main contributor to long-term morbidity in NMDAR encephalitis and persist beyond functional neurological recovery. Nonetheless, cognitive improvement is possible for several years after the acute phase and should be supported by continued cognitive rehabilitation. Cognition should be included as an outcome measure in future clinical studies

Long‐Term Cognitive Outcome in Anti–N‐Methyl‐D‐Aspartate Receptor Encephalitis

Objective Cognitive dysfunction is a core symptom of anti–N‐methyl‐D‐aspartate receptor (NMDAR) encephalitis, but detailed studies on prevalence, characteristics of cognitive deficits, and the potential for recovery are missing. Here, we performed a prospective longitudinal study to assess cognitive long‐term outcome and identify clinical predictors. Methods Standardized comprehensive neuropsychological assessments were performed in 43 patients with NMDAR encephalitis 2.3 years and 4.9 years (median) after disease onset. Cognitive assessments covered executive function, working memory, verbal/visual episodic memory, attention, subjective complaints, and depression and anxiety levels. Cognitive performance of patients was compared to that of 30 healthy participants matched for age, sex, and education. Results All patients had persistent cognitive deficits 2.3 years after onset, with moderate or severe impairment in >80% of patients. Core deficits included memory and executive function. After 4.9 years, significant improvement of cognitive function was observed, but moderate to severe deficits persisted in two thirds of patients, despite favorable functional neurological outcomes (median modified Rankin Scale = 1). Delayed treatment, higher disease severity, and longer duration of the acute phase were predictors for impaired cognitive outcome. The recovery process was time dependent, with greater gains earlier after the acute phase, although improvements were possible for several years after disease onset. Interpretation Cognitive deficits are the main contributor to long‐term morbidity in NMDAR encephalitis and persist beyond functional neurological recovery. Nonetheless, cognitive improvement is possible for several years after the acute phase and should be supported by continued cognitive rehabilitation. Cognition should be included as an outcome measure in future clinical studies. ANN NEUROL 2021;90:949–961Bundesministerium für Bildung und Forschung http://dx.doi.org/10.13039/501100002347Deutsche Forschungsgemeinschaft http://dx.doi.org/10.13039/501100001659Peer Reviewe

Beam-Normal Single Spin Asymmetry in Elastic Electron Scattering off 28^{28}Si and 90^{90}Zr

We report on a new measurement of the beam-normal single spin asymmetry $A_{\mathrm{n}}$ in the elastic scattering of 570 MeV transversely polarized electrons off $^{28}$Si and $^{90}$Zr at $Q^{2}=0.04\, \mathrm{GeV}^2/c^2$. The studied kinematics allow for a comprehensive comparison with former results on $^{12}$C. No significant mass dependence of the beam-normal single spin asymmetry is observed in the mass regime from $^{12}$C to $^{90}$Zr.Comment: Submitted for publication to Physics Letters

Differential Susceptibility to Hypertension Is Due to Selection during the Out-of-Africa Expansion

Hypertension is a leading cause of stroke, heart disease, and kidney failure. The genetic basis of blood pressure variation is largely unknown but is likely to involve genes that influence renal salt handling and arterial vessel tone. Here we argue that susceptibility to hypertension is ancestral and that differential susceptibility to hypertension is due to differential exposure to selection pressures during the out-of-Africa expansion. The most important selection pressure was climate, which produced a latitudinal cline in heat adaptation and, therefore, hypertension susceptibility. Consistent with this hypothesis, we show that ecological variables, such as latitude, temperature, and rainfall, explain worldwide variation in heat adaptation as defined by seven functional alleles in five genes involved in blood pressure regulation. The latitudinal cline in heat adaptation is consistent worldwide and is largely unmatched by latitudinal clines in short tandem repeat markers, control single nucleotide polymorphisms, or non-functional single nucleotide polymorphisms within the five genes. In addition, we show that latitude and one of these alleles, GNB3 (G protein β3 subunit) 825T, account for a major portion of worldwide variation in blood pressure. These results suggest that the current epidemic of hypertension is due to exposures of the modern period interacting with ancestral susceptibility. Modern populations differ in susceptibility to these new exposures, however, such that those from hot environments are more susceptible to hypertension than populations from cold environments. This differential susceptibility is likely due to our history of adaptation to climate

Low birth weight is associated with chronic kidney disease only in men

The association of low birth weight and chronic kidney disease was examined in a screened volunteer population by the National Kidney Foundation's Kidney Early Evaluation Program. This is a free, community-based health program enrolling individuals aged 18 years or older with diabetes, hypertension, or a family history of kidney disease, diabetes, or hypertension. Self-reported birth weight was categorized and chronic kidney disease defined as an estimated glomerular filtration rate less than 60 ml per min per 1.73 m2 or a urine albumin/creatinine ratio ≥30 mg/g. Among 12 364 participants, 15% reported a birth weight less than 2500 g. In men, significant corresponding odds ratios were found after adjustment for demographic characteristics and health conditions to this low birth weight and chronic kidney disease, but there was no association among women. There was no significant interaction between birth weight and race for either gender. Efforts to clinically understand the etiology of this association and potential means of prevention are essential to improving public health

Measurement of polarization transfer in the quasi-elastic 40Ca(e⃗,e′p⃗)^{40}{\rm Ca}(\vec{e},e' \vec{p}) process

Polarization transfer to a bound proton in polarized electron knock-out reactions, $\mathrm{A}(\vec{e},e^{\prime}\vec{p})$, is a powerful tool to look for in-medium modification of the bound proton. It requires comparison to calculations which consider the many-body effects accompanying the quasi-free process. We report here measured components $P_x^{\prime}$, $P_z^{\prime}$, and their ratio $P_x^{\prime}/P_z^{\prime}$, of polarization transfer to protons bound in $^{40}\mathrm{Ca}$, which is described well by the shell model and for which reliable calculations are available. While the calculations capture the essence of the data, our statistical precision allows us to observe deviations which cannot be explained by simple scaling, including by varying the proton electromagnetic form factor ratio $G_E/G_M$. We further explore the deviations of the ratio of the polarization transfer components from that of a free proton, $(P_x^{\prime}/P_z^{\prime})_{\rm A}/(P_x^{\prime}/P_z^{\prime})_{\rm H}$, and its dependence on the bound-proton virtuality

High accuracy synchrotron radiation interferometry with relativistic electrons

A high-precision hypernuclear experiment has been performed at the Mainz Microtron (MAMI) to determine the hypertriton {\Lambda} binding energy via decay-pion spectroscopy. A key element of this measurement is an accurate calibration of the magnetic spectrometers with the MAMI beam. For such an absolute calibration with small statistical and systematic uncertainties the undulator light interference method will be applied. In this contribution the basic principle of this method is discussed and the analysis status of the measured synchrotron radiation spectra is presentedComment: The 13th Biennial Conference on Classical and Quantum Relativistic Dynamics of Particles and Fields (IARD22