Predictive Value of \u3csup\u3e18\u3c/sup\u3eF-Florbetapir and \u3csup\u3e18\u3c/sup\u3eF-FDG PET for Conversion from Mild Cognitive Impairment to Alzheimer Dementia

© 2020 by the Society of Nuclear Medicine and Molecular Imaging. The present study examined the predictive values of amyloid PET, 18F-FDG PET, and nonimaging predictors (alone and in combination) for development of Alzheimer dementia (AD) in a large population of patients with mild cognitive impairment (MCI). Methods: The study included 319 patients with MCI from the Alzheimer Disease Neuroimaging Initiative database. In a derivation dataset (n = 159), the following Cox proportional-hazards models were constructed, each adjusted for age and sex: amyloid PET using 18F-florbetapir (pattern expression score of an amyloid-β AD conversion-related pattern, constructed by principle-components analysis); 18F-FDG PET (pattern expression score of a previously defined 18F-FDG-based AD conversion-related pattern, constructed by principle-components analysis); nonimaging (functional activities questionnaire, apolipoprotein E, and mini-mental state examination score); 18F-FDG PET + amyloid PET; amyloid PET + nonimaging; 18F-FDG PET + nonimaging; and amyloid PET + 18F-FDG PET + nonimaging. In a second step, the results of Cox regressions were applied to a validation dataset (n = 160) to stratify subjects according to the predicted conversion risk. Results: On the basis of the independent validation dataset, the 18F-FDG PET model yielded a significantly higher predictive value than the amyloid PET model. However, both were inferior to the nonimaging model and were significantly improved by the addition of nonimaging variables. The best prediction accuracy was reached by combining 18F-FDG PET, amyloid PET, and nonimaging variables. The combined model yielded 5-y free-of-conversion rates of 100%, 64%, and 24% for the low-, medium- and high-risk groups, respectively. Conclusion:18F-FDG PET, amyloid PET, and nonimaging variables represent complementary predictors of conversion from MCI to AD. Especially in combination, they enable an accurate stratification of patients according to their conversion risks, which is of great interest for patient care and clinical trials

Ultrasonic techniques to obtain dental pulp from impacted third molars

In the dental clinic impacted teeth are frequent findings, especially upper and lower third molars, leading to their exodontia. Among surgical techniques piezosurgery is advantageous for delicate structures in the oral cavity. Extracted teeth, usually di

A Microsoft-Excel-based tool for running and critically appraising network meta-analyses--an overview and application of NetMetaXL.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.BACKGROUND: The use of network meta-analysis has increased dramatically in recent years. WinBUGS, a freely available Bayesian software package, has been the most widely used software package to conduct network meta-analyses. However, the learning curve for WinBUGS can be daunting, especially for new users. Furthermore, critical appraisal of network meta-analyses conducted in WinBUGS can be challenging given its limited data manipulation capabilities and the fact that generation of graphical output from network meta-analyses often relies on different software packages than the analyses themselves. METHODS: We developed a freely available Microsoft-Excel-based tool called NetMetaXL, programmed in Visual Basic for Applications, which provides an interface for conducting a Bayesian network meta-analysis using WinBUGS from within Microsoft Excel. . This tool allows the user to easily prepare and enter data, set model assumptions, and run the network meta-analysis, with results being automatically displayed in an Excel spreadsheet. It also contains macros that use NetMetaXL's interface to generate evidence network diagrams, forest plots, league tables of pairwise comparisons, probability plots (rankograms), and inconsistency plots within Microsoft Excel. All figures generated are publication quality, thereby increasing the efficiency of knowledge transfer and manuscript preparation. RESULTS: We demonstrate the application of NetMetaXL using data from a network meta-analysis published previously which compares combined resynchronization and implantable defibrillator therapy in left ventricular dysfunction. We replicate results from the previous publication while demonstrating result summaries generated by the software. CONCLUSIONS: Use of the freely available NetMetaXL successfully demonstrated its ability to make running network meta-analyses more accessible to novice WinBUGS users by allowing analyses to be conducted entirely within Microsoft Excel. NetMetaXL also allows for more efficient and transparent critical appraisal of network meta-analyses, enhanced standardization of reporting, and integration with health economic evaluations which are frequently Excel-based.CC is a recipient of a Vanier Canada Graduate Scholarship from the Canadian Institutes of Health Research (funding reference number—CGV 121171) and is a trainee on the Canadian Institutes of Health Research Drug Safety and Effectiveness Network team grant (funding reference number—116573). BH is funded by a New Investigator award from the Canadian Institutes of Health Research and the Drug Safety and Effectiveness Network. This research was partly supported by funding from CADTH as part of a project to develop Excel-based tools to support the conduct of health technology assessments. This research was also supported by Cornerstone Research Group

On composite likelihood in bivariate meta-analysis of diagnostic test accuracy studies

The composite likelihood (CL) is amongst the computational methods used for estimation of the generalized linear mixed model (GLMM) in the context of bivariate meta-analysis of diagnostic test accuracy studies. Its advantage is that the likelihood can be derived conveniently under the assumption of independence between the random effects, but there has not been a clear analysis of the merit or necessity of this method. For synthesis of diagnostic test accuracy studies, a copula mixed model has been proposed in the biostatistics literature. This general model includes the GLMM as a special case and can also allow for flexible dependence modelling, different from assuming simple linear correlation structures, normality and tail independence in the joint tails. A maximum likelihood (ML) method, which is based on evaluating the bi-dimensional integrals of the likelihood with quadrature methods has been proposed, and in fact it eases any computational difficulty that might be caused by the double integral in the likelihood function. Both methods are thoroughly examined with extensive simulations and illustrated with data of a published meta-analysis. It is shown that the ML method has non-convergence issues or computational difficulties and at the same time allows estimation of the dependence between study-specific sensitivity and specificity and thus prediction via summary receiver operating curves

A monolithic ASIC demonstrator for the Thin Time-of-Flight PET scanner

Time-of-flight measurement is an important advancement in PET scanners to improve image reconstruction with a lower delivered radiation dose. This article describes the monolithic ASIC for the TT-PET project, a novel idea for a high-precision PET scanner for small animals. The chip uses a SiGe Bi-CMOS process for timing measurements, integrating a fully-depleted pixel matrix with a low-power BJT-based front-end per channel, integrated on the same 100 µm thick die. The target timing resolution of the scanner is 30 ps RMS for electrons from the conversion of 511 keV photons. The system will include 1.6 million channels across almost 2000 different chips. A full-featured demonstrator chip with a 3×10 matrix of 500×500 µm2 pixels was fabricated to validate each block. Its design and experimental results are presented here. © 2019 CERN

The Complexity of Flat Freeze LTL

We consider the model-checking problem for freeze LTL on one-counter automata (OCAs). Freeze LTL extends LTL with the freeze quantifier, which allows one to store different counter values of a run in registers so that they can be compared with one another. As the model-checking problem is undecidable in general, we focus on the flat fragment of freeze LTL, in which the usage of the freeze quantifier is restricted. Recently, Lechner et al. showed that model checking for flat freeze LTL on OCAs with binary encoding of counter updates is decidable and in 2NEXPTIME. In this paper, we prove that the problem is, in fact, NEXPTIME-complete no matter whether counter updates are encoded in unary or binary. Like Lechner et al., we rely on a reduction to the reachability problem in OCAs with parameterized tests (OCAPs). The new aspect is that we simulate OCAPs by alternating two-way automata over words. This implies an exponential upper bound on the parameter values that we exploit towards an NP algorithm for reachability in OCAPs with unary updates. We obtain our main result as a corollary

ACONDICIONAMENTO E ROTULAGEM DO CHÁ DE CAPIM-LIMÃO (Cymbo-pogon citratus (D.C.) Stapf) COMERCIALIZADO PELO SEGMENTO SUPERMERCADO NA CIDADE DE CURITIBA1

Introduce informations about packaging and labelling of lemon grass , Cymbopogon citratus (D.C.) Stapf tea trademarks commercialized by supermarkets in Curitiba city. These informations were obtained between august and december of 2001, through field research, participative observation and legal documents. On totality, were identified and analysed 19 trademarks of lemon grass tea, 47,36% of them were from Paraná State. It was verified that 68,4% of trademarks were packed in secondary or terciary packages and 35,6% showed primary packages, as the package was in direct contact with food. About the labelling, the majority of trademarks analysed were suitable with the actual legislation in almost totality of considerated questions. The more frequent mistake was about the sale designation. It was registered the lack of nutritional information in two third parts of avaliated trademarks, by the time of the research. Later analyses allowed to evidence the adequation of near 56% of this trademarks about that question. Key-words: food, quality, labelling.Apresentam-se informações sobre acondicionamento e rotulagem das marcas de chá de capim- limão (Cymbopogon citratus (D.C.) Stapf), comercializadas pelo segmento supermercado na cidade de Curitiba. Tais informações foram obtidas, no período de agosto a outubro de 2001, por meio de pesquisa de campo, observação participante e documentação legal. No total, foram identificadas e analisadas 19 marcas de chá de capim-limão, sendo 47,36% de procedência paranaense. Constatou-se que 68,4% das marcas estavam acondicionadas em embalagens secundárias ou terciárias e 35,6% apresentavam-se em embalagens primárias, ou seja, a embalagem em contato direto com o alimento. Quanto à rotulagem, a maioria das marcas analisadas apresentava-se adequada à legislação vigente no que concerne à quase totalidade dos parâmetros considerados. A incorreção mais freqüente foi com relação à denominação de venda. Registrou-se ausência de rotulagem nutricional em cerca de dois terços das marcas analisadas, na época da pesquisa. Constatou-se por meio de análise comprobatória posterior, a adequação de cerca de 56% destas marcas, quanto à rotulagem correta da embalagem. Palavras-chave: alimento, qualidade, embalagem

Treatment of depressive disorders in primary care - protocol of a multiple treatment systematic review of randomized controlled trials

Background: Several systematic reviews have summarized the evidence for specific treatments of primary care patients suffering from depression. However, it is not possible to answer the question how the available treatment options compare with each other as review methods differ. We aim to systematically review and compare the available evidence for the effectiveness of pharmacological, psychological, and combined treatments for patients with depressive disorders in primary care. Methods/Design: To be included, studies have to be randomized trials comparing antidepressant medication (tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), hypericum extracts, other agents) and/or psychological therapies (e.g. interpersonal psychotherapy, cognitive therapy, behavioural therapy, short dynamically-oriented psychotherapy) with another active therapy, placebo or sham intervention, routine care or no treatment in primary care patients in the acute phase of a depressive episode. Main outcome measure is response after completion of acute phase treatment. Eligible studies will be identified from available systematic reviews, from searches in electronic databases (Medline, Embase and Central), trial registers, and citation tracking. Two reviewers will independently extract study data and assess the risk of bias using the Cochrane Collaboration's corresponding tool. Meta-analyses (random effects model, inverse variance weighting) will be performed for direct comparisons of single interventions and for groups of similar interventions (e.g. SSRIs vs. tricyclics) and defined time-windows (up to 3 months and above). If possible, a global analysis of the relative effectiveness of treatments will be estimated from all available direct and indirect evidence that is present in a network of treatments and comparisons. Discussion: Practitioners do not only want to know whether there is evidence that a specific treatment is more effective than placebo, but also how the treatment options compare to each other. Therefore, we believe that a multiple treatment systematic review of primary-care based randomized controlled trials on the most important therapies against depression is timely