Comparison and aggregation of event sequences across ten cohorts to describe the consensus biomarker evolution in Alzheimer's disease

BACKGROUND: Previous models of Alzheimer's disease (AD) progression were primarily hypothetical or based on data originating from single cohort studies. However, cohort datasets are subject to specific inclusion and exclusion criteria that influence the signals observed in their collected data. Furthermore, each study measures only a subset of AD-relevant variables. To gain a comprehensive understanding of AD progression, the heterogeneity and robustness of estimated progression patterns must be understood, and complementary information contained in cohort datasets be leveraged. METHODS: We compared ten event-based models that we fit to ten independent AD cohort datasets. Additionally, we designed and applied a novel rank aggregation algorithm that combines partially overlapping, individual event sequences into a meta-sequence containing the complementary information from each cohort. RESULTS: We observed overall consistency across the ten event-based model sequences (average pairwise Kendall's tau correlation coefficient of 0.69 ± 0.28), despite variance in the positioning of mainly imaging variables. The changes described in the aggregated meta-sequence are broadly consistent with the current understanding of AD progression, starting with cerebrospinal fluid amyloid beta, followed by tauopathy, memory impairment, FDG-PET, and ultimately brain deterioration and impairment of visual memory. CONCLUSION: Overall, the event-based models demonstrated similar and robust disease cascades across independent AD cohorts. Aggregation of data-driven results can combine complementary strengths and information of patient-level datasets. Accordingly, the derived meta-sequence draws a more complete picture of AD pathology compared to models relying on single cohorts

Infrared spectroscopy of asymptotic giant branch stars in the Galactic bulge

We have selected a homogeneous sample of asymptotic giant branch (AGB) stars in theGalactic bulge population from the ISOGAL survey. Our target stars cover a wide range of mass-loss rates (~10-8-10-4 M⊙ yr-1) and differ primarily by their age on the AG

Evaluation of the modified HTK solution in pancreas transplantationdAn experimental model

One of the great challenges in pancreas transplantation is the ischemia reperfusion injury. It is mentioned that free oxygen and/or nitrogen radicals play a prominent role in this phase. To minimize this problem, a modified histidineetryptophan eketoglutarate (HTK) solution that contains modified antioxidants has been developed. Our aim was to evaluate this solution in improving the viability of the pancreas in comparison with standard HTK and University of Wisconsin (UW) solutions in a porcine model of pancreas transplantation

Comparison of the efficacy of a neutral wrist splint and wrist splint with lumbrical unit for the treatment of patients with carpal tunnel syndrome

Purpose: The purpose of this study was to compare the effect of a neutral wrist splint or a wrist splint with an additional metacarpophalangeal (MCP) unit on pain, function, grip and pinch strength in patients with mild-to-moderate carpal tunnel syndrome (CTS). Methods: Twenty four patients received conservative treatment using either the neutral wrist splint or wrist splint with the MCP unit for a period of 6 weeks. Primary outcome measures were pain, function, grip and pinch strength. Data was collected immediately before and after using the two types of splints at baseline (0 weeks) and 6 weeks. Statistical analysis was performed using the paired t-test and independent T-test. Results: Compared to baseline, both the neutral wrist splint and the wrist splint with an MCP unit significantly decreased pain, increased function and pinch and grip strength. Comparisons of the two types of splints for grip (P =0.675) and pinch strength (P =0.650) revealed that there were no significant differences between the two after 6 weeks of wear. However, there were significant differences in pain levels (P =0.022) and the DASH score (P =0.027) between the two types of splints from baseline to 6 weeks. Conclusion: The wrist splint with an MCP unit was more effective than the neutral wrist splint in pain reduction and improvement of function

Infrared spectroscopy of asymptotic giant branch stars in the Galactic bulge

We have selected a homogeneous sample of asymptotic giant branch (AGB) stars in the Galactic bulge population from the ISOGAL survey. Our target stars cover a wide range of mass-loss rates (∼10−8-10−4 M⊙ yr−1) and differ primarily by their age on the AGB. This homogeneous sample is thus ideally suited to study the dust formation process as a function of age on the AGB. We observed our sample with Spitzer-Infrared Spectrograph, and studied the overall properties of the infrared spectra of these targets. The analysis is complicated by the presence of strong and variable background emission, and the extracted infrared AGB star spectra are affected by interstellar extinction. Several stars in our sample have no detectable dust emission, and we used these ‘naked stars’ to characterize the stellar and molecular contributions to the infrared spectra of our target stars. The resulting dust spectra of our targets do indeed show significant variety in their spectral appearance, pointing to differing dust compositions for the targets. We classify the spectra based on the shape of their 10-μm emission following the scheme by Sloan & Price. We find that the early silicate emission classes associated with oxide dust are generally under-represented in our sample due to extinction effects. We also find a weak 13-μm dust feature in two of our otherwise naked star spectra, suggesting that the carrier of this feature could potentially be the first condensate in the sequence of dust condensation

One life ends, another begins: Management of a brain-dead pregnant mother - A systematic review -

Background: An accident or a catastrophic disease may occasionally lead to brain death (BD) during pregnancy. Management of brain-dead pregnant patients needs to follow special strategies to support the mother in a way that she can deliver a viable and healthy child and, whenever possible, also be an organ donor. This review discusses the management of brain-dead mothers and gives an overview of recommendations concerning the organ supporting therapy. Methods: To obtain information on brain-dead pregnant women, we performed a systematic review of Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL). The collected data included the age of the mother, the cause of brain death, maternal medical complications, gestational age at BD, duration of extended life support, gestational age at delivery, indication of delivery, neonatal outcome, organ donation of the mothers and patient and graft outcome. Results: In our search of the literature, we found 30 cases reported between1982 and 2010. A nontraumatic brain injury was the cause of BD in 26 of 30 mothers. The maternal mean age at the time of BD was 26.5 years. The mean gestational age at the time of BD and the mean gestational age at delivery were 22 and 29.5 weeks, respectively. Twelve viable infants were born and survived the neonatal period. Conclusion: The management of a brain-dead pregnant woman requires a multidisciplinary team which should follow available standards, guidelines and recommendations both for a nontraumatic therapy of the fetus and for an organ-preserving treatment of the potential donor

Exergy Analysis and Performance Evaluation of CNG to LNG Converting Process

Abstract: A process for converting Compressed Natural Gas (CNG) to Liquefied Natural Gas (LNG) is modelled thermodynamically and effects of design and operating parameters on exergy destruction and performance of the process are studied. Results show that CNG pressure, pressure after Joule–Thomson valve, and temperature of CNG after heat exchanger of refrigerating system have significant effects on optimum design and operation of the process. The results also indicate that the effects of CNG temperature after CNG production section, and pinch temperature of the last heat exchanger of the process are considerable. To determine the effects of natural gas composition on operating the CNG to LNG converting (CLC) process, variation of nitrogen as the most effective content of natural gas on operating the process has been studied and discussed