Spatial distribution of white matter degenerative lesions and cognitive dysfunction in relapsing-remitting multiple sclerosis patients

Aim. The aim of this study was to assess degenerative lesion localisation in the course of relapsing-remitting multiple sclerosis (RRMS) and to identify the association between localisation and the frequency of T1-hypointense lesions (black holes) with cognitive dysfunction. We also searched for neuroradiological predictors of cognitive dysfunction in patients. The clinical rationale for the study was previous research, and our own findings suggest that lesion localisation plays an important role in cognitive performance and neurological disability of MS patients. Material and methods. Forty-two patients were included in the study. All subjects underwent neuropsychological examination using Raven’s Coloured Progressive Matrices, a naming task from the Brief Repeatable Battery of Neuropsychological Tests, and attention to detail tests. Magnetic resonance imaging (MRI) was acquired on 1.5 Tesla scanner and black holes were manually segmented on T1-weighted volumetric images using the FMRIB Software Library. Linear regression was applied to establish a relationship between black hole volume per lobe and cognitive parameters. Bonferroni correction of voxelwise analysis was used to correct for multiple comparisons. Results. The following associations between black hole volume and cognition were identified: frontal lobes black hole volume was associated with phonemic verbal fluency (t = –4.013, p < 0.001), parietal black hole volume was associated with attention (t = –3.776, p < 0.001), and parietal and temporal black hole volumes were associated with nonverbal intelligence (p < 0.001). The volume of parietal black holes was the best predictor of cognitive dysfunction. Conclusions. Our approach, including measurement of focal axonal loss based on T1-volumetric MRI sequence and brief neuropsychological assessment, might improve personalised diagnostic and therapeutic decisions in clinical practice

Inclusion of juvenile stages improves diversity assessment and adds to our understanding of mite ecology – A case study from mires in Norway

Arachnid orders, Mesostigmata, Trombidiformes, and Sarcoptiformes, commonly known as ‘mites’, are abundant in mires, both as adults and as juveniles. However, due to the challenges of identification, the juvenile forms are often excluded from analyses. This is the first study in mires that included all three mite orders identified to the species level, including juvenile instars. We aimed to compare how diversity and the response to ecological variables differed if only the adults (ad) vs. the total number of specimens (ad+juv) are considered. Samples of 20 Sphagnum species (five subgenera) were collected and mites were extracted using Berlese funnels. Overall, nearly 60,000 mites were analyzed; of these Mesostigmata made up 1.87% of the total, Trombidiformes −0.27%, and Sarcoptiformes −97.86%. The study revealed 154 species (33 Mesostigmata, 24 Trombidiformes, and 97 Sarcoptiformes), the highest diversity of mites ever reported from mires. The inclusion of juveniles increased observed species richness by 6%, with 10 species (one Mesostigmata, six Trombidiformes, and three Sarcoptiformes) represented only by juvenile forms. Seventeen species are new to Norway (four Mesostigmata, one Sarcoptiformes, and 12 Trombidiformes, including five undescribed species of Stigmaeidae and Cunaxidae). Four of these were represented in the samples only by juveniles. Including the juveniles explained a greater amount of the variability of Trombidiformes (explanatory variables account for 23.60% for ad, and 73.74% for ad+juv) and Mesostigmata (29.23% − ad, 52.91% − ad+juv), but had less of an impact for Sarcoptiformes (38.48% − ad, 39.26% − ad+juv). Locality, Sphagnum subgenus and species, wetness, and trophic state significantly affected the mite communities and should be taken into consideration when studying mires. Since juvenile stages contribute significantly to mite diversity in mires, they should also be included in mite studies in other habitats.publishedVersio

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines

Ultrasonograficzne wykładniki miażdżycy tętnic szyjnych wykazują korelację z liczbą klasycznych czynników ryzyka miażdżycy

Background and purpose Ultrasound-based indicators such as mean or maximal carotid intima-media thickness (CIMT) and cross-sectional plaque area (C-SPA) have been shown to be measurable indices of atherosclerosis. We investigated whether those indicators correlated with the number of atherosclerotic risk factors assessed in routine clinical practice. Materials and methods The study involved a group of 150 patients (median age, 65 years). High-resolution ultrasound was used to assess CIMT and C-SPA of their common and internal carotid arteries. The number of risk factors derived from clinical examination (e.g., hypertension, diabetes, smoking), haematological test, acute phase proteins, serum lipoproteins, homocysteine, and body mass index was assessed. Results Plaques occurred in 85 patients (57% of participants). The median plaque area was 21 mm2 (10.7–46.5 mm2), and the mean CIMT was 0.88 mm (standard deviation, 0.28 mm). The study found significant associations among most of the single as well as the total number of risk factors and mean and maximal CIMT and C-SPA. The differences among the groups of patients with different numbers of risk factors were more evident in terms of the maximal and mean CIMT than in the case of C-SPA. Assessment of C-SPA could be statistically underpowered because only 57% of the investigated subjects had plaques in their carotid arteries. Conclusions We found a significant correlation between the total number of atherosclerosis risk factors and carotid atherosclerosis as measured by ultrasonography. Along with an increase of the number of risk factors, a gradual increase of CIMT and C-SPA was observed.Wstęp i cel pracy Ultrasonograficzne parametry morfologiczne tętnic szyjnych, takie jak średnia i maksymalna grubość błony środkowej i wewnętrznej ściany naczyniowej (grubość kompleksu inuma–media, GKIM) oraz powierzchnia przekroju poprzecznego (PP) blaszek miażdżycowych, są uznanymi wykładnikami miażdżycy. Celem pracy było zbadanie, czy istnieje zależność pomiędzy liczbą czynników ryzyka rozwoju miażdżycy ocenianych w rutynowej praktyce klinicznej a zmianami GKIM oraz występowaniem i wielkością powierzchni PP blaszek miażdżycowych w zewnątrzczaszkowych odcinkach tętnic szyjnych. Materiał i metody W badaniu wzięło udział 150 pacjentów (mediana wieku: 65 lat). Powierzchnię PP blaszek miażdżycowych oraz GKIM w zewnątrzczaszkowym odcinku tętnic szyjnych wspólnych i wewnętrznych oceniono przy użyciu ultrasonografii wysokiej rozdzielczości. Liczbę czynników ryzyka miażdżycy określano na podstawie badania klinicznego (nadciśnienie tętnicze, cukrzyca, palenie tytoniu) oraz laboratoryjnych oznaczeń hematologicznych, badania białek ostrej fazy, lipoprotein, homocysteiny i wskaźnika masy ciała. Wyniki Blaszki miażdżycowe występowały u 85 pacjentów (57%). Mediana powierzchni PP blaszki wynosiła 21 mm2 (10,7–46,5 mm2), a średnia GKIM 0,88 mm (odchylenie standardowe: 0,28 mm). Stwierdzono zależność pomiędzy występowaniem większości pojedynczych czynników ryzyka oraz ich całkowitą liczbą a średnią i maksymalną GKIM oraz powierzchnią PP blaszek. Najsilniejsze korelacje zaobserwowano dla średniej i maksymalnej GKIM, a następnie dla powierzchni PP blaszek miażdżycowych. Korelacja pomiędzy powierzchnią PP blaszek a liczbą czynników ryzyka mogła być niedoszacowana, ponieważ tylko u 57% badanych osób stwierdzono blaszki miażdżycowe. Wnioski Stwierdzono istotną zależność pomiędzy liczbą czynników ryzyka a wykładnikami miażdżycy tętnic szyjnych ocenionych metodą ultrasonografii. Wraz ze zwiększaniem się liczby czynników ryzyka miażdżycy obserwowano stopniowy wzrost zarówno GKIM, jak i powierzchni PP blaszek miażdżycowych

The taxonomy statistic uncovers novel clinical patterns in a population of ischemic stroke patients.

In this paper, we describe a simple taxonomic approach for clinical data mining elaborated by Marczewski and Steinhaus (M-S), whose performance equals the advanced statistical methodology known as the expectation-maximization (E-M) algorithm. We tested these two methods on a cohort of ischemic stroke patients. The comparison of both methods revealed strong agreement. Direct agreement between M-S and E-M classifications reached 83%, while Cohen's coefficient of agreement was κ = 0.766(P < 0.0001). The statistical analysis conducted and the outcomes obtained in this paper revealed novel clinical patterns in ischemic stroke patients. The aim of the study was to evaluate the clinical usefulness of Marczewski-Steinhaus' taxonomic approach as a tool for the detection of novel patterns of data in ischemic stroke patients and the prediction of disease outcome. In terms of the identification of fairly frequent types of stroke patients using their age, National Institutes of Health Stroke Scale (NIHSS), and diabetes mellitus (DM) status, when dealing with rough characteristics of patients, four particular types of patients are recognized, which cannot be identified by means of routine clinical methods. Following the obtained taxonomical outcomes, the strong correlation between the health status at moment of admission to emergency department (ED) and the subsequent recovery of patients is established. Moreover, popularization and simplification of the ideas of advanced mathematicians may provide an unconventional explorative platform for clinical problems

Mapping of guest localization in mesoporous silica particles by solid-state NMR and Ab initio modeling: New insights into benzoic acid and p-fluorobenzoic acid embedded in MCM-41 via ball milling

We present a novel strategy for mapping the localization of guest molecules (GMs) in mesoporous materials by combining mechanochemistry with solid-state nuclear magnetic resonance (ssNMR) spectroscopy. To this end, we consider model guest–host systems of benzoic acid (BA) and para-fluorobenzoic acid (4-FBA) embedded in mesoporous MCM-41 material and examine the recently proposed loading (MeLo) procedure for efficient encapsulation of molecular species. Application of high-resolution NMR experiments (1H and 19F NMR) has allowed detection of a multimodal distribution of the spectral signals ascribed to embedded GMs. This peculiarity reflects the presence of distinct molecular ensembles subjected to intrinsically different local environments and exhibiting different dynamical behavior. Furthermore, a considerable fraction of an amorphous phase has been found as a byproduct of the ball-milling. The stability of the phase mixture was further checked by subjecting the samples to chemical and physical stimuli, and a detailed interpretation of the NMR data was corroborated by theoretical calculations. To this end, we have undertaken a challenge to predict the NMR spectra of the GMs@MCM-41 using advanced ab initio molecular dynamics (AIMD) simulations, providing an accurate and exhaustive analysis of the NMR spectra. On the basis of the ab initio modeling validated against the experimental results, we find that the multimodal signal distribution reflects the level of the pore filling, and can be ascribed to the presence of both interface and fluid molecular species trapped inside the pores. This has been confirmed for both BA@MCM-41 and 4-FBA@MCM-41 systems. The presence of the third, amorphous fraction can be linked to interstitial space between randomly ordered crystallites, pointing at the importance of the external surface in further stabilization of encapsulated materials. Altogether, a consistent experimental and theoretical methodology has been presented, paving the way for a more accurate analysis of complex nanoconfined systems.The work has been financed by the National Science Centre of Poland (Grant No. 2018/31B/ST4/01973) and supported by PL-Grid Infrastructure (Grant ID: lattice dynamics).Peer reviewe

Means of mRS scores vs. types of stroke patients at 30, 90, 180, and 360 days after onset of stroke (following the E-M classification).

<p>Means of mRS scores vs. types of stroke patients at 30, 90, 180, and 360 days after onset of stroke (following the E-M classification).</p

Characteristics of stroke patients following M-S classification (for age, NIHSS score, and DM status).

<p>Characteristics of stroke patients following M-S classification (for age, NIHSS score, and DM status).</p

Classification of stroke patients.

<p>Classification of stroke patients.</p

Means of mRankin’s scores vs. Types of stroke patients at 30, 90, 180, and 360 days after onset of stroke (following M-S classification).

<p>Means of mRankin’s scores vs. Types of stroke patients at 30, 90, 180, and 360 days after onset of stroke (following M-S classification).</p