Aging, Cognitive Decline and Hearing Loss: Effects of Auditory Rehabilitation and Training with Hearing Aids and Cochlear Implants on Cognitive Function and Depression among Older Adults

A growing interest in cognitive effects associated with speech and hearing processes is spreading throughout the scientific community essentially guided by evidence that central and peripheral hearing loss is associated with cognitive decline. For the present research, 125 participants older than 65 years of age (105 with hearing impairment and 20 with normal hearing) were enrolled, divided into 6 groups according to their degree of hearing loss and assessed to determine the effects of the treatment applied. Patients in our research program routinely undergo an extensive audiological and cognitive evaluation protocol providing results from the Digit Span test, Stroop color-word test, Montreal Cognitive Assessment and Geriatric Depression Scale, before and after rehabilitation. Data analysis was performed for a cross-sectional and longitudinal study of the outcomes for the different treatment groups. Each group demonstrated improvement after auditory rehabilitation or training on shortand long-term memory tasks, level of depression and cognitive status scores. Auditory rehabilitation by cochlear implants or hearing aids is effective also among older adults (median age of 74 years) with different degrees of hearing loss, and enables positive improvements in terms of social isolation, depression and cognitive performance

Update on Vertigo in Autoimmune Disorders, from Diagnosis to Treatment

The prevalence of autoimmune diseases has been increasing over the last 20 years. The clinical presentation of this large and heterogeneous group of disorders depends on whether the involvement is organ-specific or non-organ-specific. Dizziness, vertigo, and disequilibrium are common symptoms reported by patients with vestibulocochlear involvement. The association of vertigo and autoimmune diseases has been largely documented, suggesting that autoimmune disorders could be overrepresented in patients with vertigo in comparison to the general population. The aim of this review is to present the recent literature findings in the field of autoimmune-mediated diseases with cochleovestibular involvement, focusing on the clinical presentation, diagnosis, and treatment of immune-mediated inner ear diseases including autoimmune inner ear disease (AIED), Meniere’s disease, and bilateral vestibulopathy, as well as of systemic autoimmune diseases with audiovestibular disorders, namely, Behçet’s disease, Cogan’s syndrome, sarcoidosis, autoimmune thyroid disease, Vogt-Koyanagi-Harada syndrome, relapsing polychondritis, systemic lupus erythematosus, antiphospholipid syndrome, IgG4-related disease, and ANCA-associated vasculitides

Molecular Cloud Evolution VI. Measuring cloud ages

This article has been published in Monthly Notices of the Royal Astronomical Society © 2018 The Author(s). Published by Oxford University Press on behalf of the Royal Astronomical Society. All rights reserved.In previous contributions, we have presented an analytical model describing the evolution and star formation rate (SFR) of molecular clouds (MCs) undergoing hierarchical gravitational contraction. The cloud’s evolution is characterized by an initial increase in its mass, density, SFR, and star formation efficiency (SFE), as it contracts, followed by a decrease of these quantities as newly formed massive stars begin to disrupt the cloud. The main parameter of the model is the maximum mass reached by the cloud during its evolution. Thus, specifying the instantaneous mass and some other variable completely determines the cloud’s evolutionary stage. We apply the model to interpret the observed scatter in SFEs of the cloud sample compiled by Lada et al. as an evolutionary effect so that, although clouds such as California and Orion A have similar masses, they are in very different evolutionary stages, causing their very different observed SFRs and SFEs. The model predicts that the California cloud will eventually reach a significantly larger total mass than the Orion A cloud. Next, we apply the model to derive estimated ages of the clouds since the time when approximately 25 per cent of their mass had become molecular. We find ages from ∼1.5 to 27 Myr, with the most inactive clouds being the youngest. Further predictions of the model are that clouds with very low SFEs should have massive atomic envelopes constituting the majority of their gravitational mass, and that low-mass clouds (M ∼ 103–104M⊙) end their lives with a mini-burst of star formation, reaching SFRs ∼300–500M⊙ Myr−1. By this time, they have contracted to become compact (∼1 pc) massive star-forming clumps, in general embedded within larger giant molecular clouds.Peer reviewe

A qualitative study exploring the process of postmortem brain tissue donation after suicide

Access to postmortem brain tissue can be valuable in refining knowledge on the pathophysiology and genetics of neuropsychiatric disorders. Obtaining postmortem consent for the donation after death by suicide can be difcult, as families may be overwhelmed by a violent and unexpected death. Examining the process of brain donation can inform on how the request can best be conducted. This is a qualitative study with in-depth interviews with forty-one people that were asked to consider brain donation—32 who had consented to donation and 9 who refused it. Data collection and analyses were carried out according to grounded theory. Five key themes emerged from data analysis: the context of the families, the invitation to talk to the research team, the experience with the request protocol, the participants’ assessment of the experience, and their participation in the study as an opportunity to heal. The participants indicated that a brain donation request that is respectful and tactful can be made without adding to the family distress brought on by suicide and pondering brain donation was seen as an opportunity to transform the meaning of the death and invest it with a modicum of solace for being able to contribute to research

A Randomized Trial of Pharmacogenetic Warfarin Dosing in Naive Patients with Non-Valvular Atrial Fibrillation

Genotype-guided warfarin dosing have been proposed to improve patient's management. This study is aimed to determine whether a CYP2C9- VKORC1- CYP4F2-based pharmacogenetic algorithm is superior to a standard, clinically adopted, pharmacodynamic method. Two-hundred naive patients with non-valvular atrial fibrillation were randomized to trial arms and 180 completed the study. No significant differences were found in the number of out-of-range INRs (INR3.0) (p = 0.79) and in the mean percentage of time spent in the therapeutic range (TTR) after 19 days in the pharmacogenetic (51.9%) and in the control arm (53.2%, p = 0.71). The percentage of time spent at INR>4.0 was significantly lower in the pharmacogenetic (0.7%) than in the control arm (1.8%) (p = 0.02). Genotype-guided warfarin dosing is not superior in overall anticoagulation control when compared to accurate clinical standard of care

Mepolizumab for Eosinophilic Granulomatosis With Polyangiitis: A European Multicenter Observational Study.

OBJECTIVE: Mepolizumab proved to be an efficacious treatment for eosinophilic granulomatosis with polyangiitis (EGPA) at a dose of 300 mg every 4 weeks in the randomized, controlled MIRRA trial. In a few recently reported studies, successful real-life experiences with the approved dose for treating severe eosinophilic asthma (100 mg every 4 weeks) were observed. We undertook this study to assess the effectiveness and safety of mepolizumab 100 mg every 4 weeks and 300 mg every 4 weeks in a large European EGPA cohort. METHODS: We included all patients with EGPA treated with mepolizumab at the recruiting centers in 2015-2020. Treatment response was evaluated from 3 months to 24 months after initiation of mepolizumab. Complete response to treatment was defined as no disease activity (Birmingham Vasculitis Activity Score [BVAS] = 0) and a prednisolone or prednisone dose (or equivalent) of ≤4 mg/day. Respiratory outcomes included asthma and ear, nose, and throat (ENT) exacerbations. RESULTS: Two hundred three patients, of whom 191 received a stable dose of mepolizumab (158 received 100 mg every 4 weeks and 33 received 300 mg every 4 weeks) were included. Twenty-five patients (12.3%) had a complete response to treatment at 3 months. Complete response rates increased to 30.4% and 35.7% at 12 months and 24 months, respectively, and rates were comparable between mepolizumab 100 mg every 4 weeks and 300 mg every 4 weeks. Mepolizumab led to a significant reduction in BVAS score, prednisone dose, and eosinophil counts from 3 months to 24 months, with no significant differences observed between 100 mg every 4 weeks and 300 mg every 4 weeks. Eighty-two patients (40.4%) experienced asthma exacerbations (57 of 158 [36%] who received 100 mg every 4 weeks; 17 of 33 [52%] who received 300 mg every 4 weeks), and 31 patients (15.3%) experienced ENT exacerbations. Forty-four patients (21.7%) experienced adverse events (AEs), most of which were nonserious AEs (38 of 44). CONCLUSION: Mepolizumab at both 100 mg every 4 weeks and 300 mg every 4 weeks is effective for the treatment of EGPA. The 2 doses should be compared in the setting of a controlled trial

Cloud Structure of Galactic OB Cluster Forming Regions from Combining Ground and Space Based Bolometric Observations

We have developed an iterative procedure to systematically combine the millimeter and submillimeter images of OB cluster-forming molecular clouds, which were taken by ground based (CSO, JCMT, APEX, IRAM-30m) and space telescopes (Herschel, Planck). For the seven luminous ($L$$>$10$^{6}$ $L_{\odot}$) Galactic OB cluster-forming molecular clouds selected for our analyses, namely W49A, W43-Main, W43-South, W33, G10.6-0.4, G10.2-0.3, G10.3-0.1, we have performed single-component, modified black-body fits to each pixel of the combined (sub)millimeter images, and the Herschel PACS and SPIRE images at shorter wavelengths. The $\sim$10$"$ resolution dust column density and temperature maps of these sources revealed dramatically different morphologies, indicating very different modes of OB cluster-formation, or parent molecular cloud structures in different evolutionary stages. The molecular clouds W49A, W33, and G10.6-0.4 show centrally concentrated massive molecular clumps that are connected with approximately radially orientated molecular gas filaments. The W43-Main and W43-South molecular cloud complexes, which are located at the intersection of the Galactic near 3-kpc (or Scutum) arm and the Galactic bar, show a widely scattered distribution of dense molecular clumps/cores over the observed $\sim$10 pc spatial scale. The relatively evolved sources G10.2-0.3 and G10.3-0.1 appear to be affected by stellar feedback, and show a complicated cloud morphology embedded with abundant dense molecular clumps/cores. We find that with the high angular resolution we achieved, our visual classification of cloud morphology can be linked to the systematically derived statistical quantities (i.e., the enclosed mass profile, the column density probability distribution function, the two-point correlation function of column density, and the probability distribution function of clump/core separations)