Markers for the detection of Lewy body disease versus Alzheimer's disease in mild cognitive impairment: a systematic review and meta-analysis

Background Mild cognitive impairment (MCI) may evolve into dementia. Early recognition of possible evolution to Alzheimer's disease (AD) and dementia with Lewy Bodies (DLB) is of importance, but actual diagnostic criteria have some limitations. In this systematic review and meta-analysis, we aimed to find the most accurate markers that can discriminate patients with DLB versus AD, in MCI stage. Methods We searched several databases up to 17 August 2023 including studies comparing markers that may distinguish DLB-MCI from AD-MCI. We reported data regarding sensitivity, specificity, and the area under the curves (AUCs) with their 95% confidence intervals (CIs). Results Among 2219 articles initially screened, eight case-control studies and one cohort study were included for a total of 832 outpatients with MCI. The accuracy of cerebrospinal fluid (CSF) markers was the highest among the markers considered (AUC > 0.90 for the CSF markers), with the AUC of CSF A beta 42/A beta 40 of 0.94. The accuracy for clinical symptom scales was very good (AUC = 0.93), as evaluated in three studies. Although limited to one study, the accuracy of FDG-PET (cingulate island sign ratio) was very good (AUC = 0.95) in discriminating DLB from AD in MCI, while the accuracy of SPECT markers and EEG frequencies was variable. Conclusions Few studies have assessed the accuracy of biomarkers and clinical tools to distinguish DLB from AD at the MCI stage. While results are promising for CSF markers, FDG-PET and clinical symptoms scales, more studies, particularly with a prospective design, are needed to evaluate their accuracy and clinical usefulness

Clinical prognostic factors for older people: A systematic review and meta-analysis

Objective: To explore the accuracy and precision of prognostic tools used in older people in predicting mortality, hospitalization, and nursing home admission across different settings and timings. Design: Systematic review and meta-analysis of prospective and retrospective studies. Data sources: A systematic search from database inception until 01st February 2023 was run in Medline, Embase, Cinhal, Cochrane Library. Eligibility criteria: Studies were eligible if they reported accuracy (area under the curve [AUC]) and/or precision (C-index) for the prognostic index in relation to any of the following outcomes: mortality, hospitalization, and nursing home admission. Data extraction and synthesis: Two independent reviewers extracted data. Data were pooled using a random effects model. The risk of bias was assessed with the Quality in Prognosis Studies (QUIPS) tool. If more than three studies for the same setting and time were available, a meta-analysis was performed and evaluated using the GRADE tool; other data were reported descriptively. Results: Among 16,082 studies initially considered, 159 studies with a total of 2398856 older people (mean age: 78 years) were included. The majority of the studies was carried out in hospital or medical wards. In the community setting, only two tools (Health Assessment Tool and the Multidimensional Prognostic Index, MPI) had good precision for long-term mortality. In emergency department setting, Barthel Index had an excellent accuracy in predicting short-term mortality. In medical wards, the MPI had a moderate certainty of the evidence in predicting short-term mortality (13 studies; 11,787 patients; AUC=0.79 and 4 studies; 3915 patients; C-index=0.82). Similar findings were available for MPI when considering longer follow-up periods. When considering nursing home and surgical wards, the literature was limited. The risk of bias was generally acceptable; observed bias was mainly owing to attrition and confounding. Conclusions: Several tools are used to predict poor prognosis in geriatric patients, but only those derived from a multidimensional evaluation have the characteristics of precision and accuracy

The power of video in science communication: the EDUlab media production

Avvicinare la scienza e la ricerca alle persone, in ogni aspetto, significa avvicinare il pubblico a temi complicati, inspirando buone norme comportamentali di rispetto e tutela ambientale ma anche avvicinare la scienza a chi ogni giorno è in grado di decidere, attraverso i finanziamenti, quali lavori scientifici supportare. Proprio in coscienza di questo, negli ultimi decenni la scienza ha smesso di essere autoreferenziale, comprendendo che divulgare contenuti altamente scientifici a ad un pubblico non specialistico è fondamentale. Divulgare vuol dire creare quell’anello di congiunzione tra la ricerca scientifica più avanzata e il pubblico, significa saper capire il linguaggio spesso criptico dei ricercatori e di adattarlo senza stravolgimenti in qualcosa di comprensibile alle persone comuni. Con questa mission, nel 2015 nasce ufficialmente il gruppo “EDULab dell’IAS-CNR di Capo Granitola”, ovvero un laboratorio creativo di divulgazione scientifica in cui ricercatori, tecnologi e tecnici di varie discipline che condividono la passione di divulgare la scienza e i risultati da essa prodotti nei propri ambiti di competenza. Nel tempo, l’attività del gruppo si è consolidata, portando a numerosi risultati e ad un numero ragguardevole di progetti e programmi. Tra gli innumerevoli prodotti divulgativi sviluppati, l’uso dei media, ed in particolare dei video, si è rivelato uno strumento eccezionale di “comunicazione empatica” attraverso cui il pubblico riesce ad “immergersi” letteralmente nei contenuti proposti, recependo e facendo propri contenuti anche molto complessi. Nell’era del web e dei social-media, infatti, i video sono ormai lo strumento più veloce ed efficace per veicolare informazioni ad un’ampia fetta di popolazione

The imaging for the the successful bio-communication: ORBS Brand

Producing accessible communication based on scientific research usually involves a great deal of effort in translating complex concepts into a non professional oriented information, but it is only through widely accessible data that knowledge dissemination have stronger repercussions in society. In concordance to this statement, the CNR IAMC and the “Accademia di Belle Arti di Palermo” collaborated in the work frame of the "Information, dissemination and communication system of the Biodiversity Observatory of Sicily” project, a synergistic interaction between science and art. The researchers held biodiversity seminars to the Academy students, involving 19 professorships, aiming to increase the knowledge degree and awareness on the biodiversity, thus stimulating their creativity. One of the main activities carried out during this collaboration was the conceptualization and designing of the Biodiversity Observatory brand, with the representation of biodiversity as the main briefing. The winning proposal was chosen between 13 projects by popular vote, with the participation of more than 800 students and CNR researchers. The branding is a representation of the environment with the use of different animal silhouettes as a symbol of biodiversity. The elements are arranged on a spiral grid suggesting movement, a current that raises deep, nutrient-rich waters to the ocean surface. Extremely evocative and appealing, the logotype has become an integral part of the Observatory's identity, and it's been profusely applied over the years on communication and divulgative materials, website, exhibitions, and memorabilia. Involving such a large number of students and their social groups (family, friends, and etcetera) meant giving the citizens a leading role in an important activity. Participation of the public in the creation of the graphic identity of a key structure in their territory resulted in a dramatic increase of sensitization on the biodiversity and environmental cause and participation in divulgation activities in the following years

Visita all'Osservatorio della Biodiversità marina e terrestre della Regione Sicilia - ORBS

Con il taglio inaugurale del nastro il 16 dicembre 2015, prende vita la struttura museale permanente dell'Osservatorio della Biodiversità marina e terrestre della Regione Sicilia che porta lo stesso nome del Progetto di Ricerca "ORBS – Sistema di comunicazione, informazione e diffusione dell'Osservatorio Regionale della Sicilia", intitolata il 21 dicembre 2018 al Dott. Sandro Fiorelli. Ad oggi, la struttura, è operativa presso la Sede Secondaria dell'Istituto per lo studio degli impatti Antropici e Sostenibilità in ambiente marino del Consiglio Nazionale delle Ricerche (IAS – CNR) di Capo Granitola. Il progetto ORBS, finanziato da Regione Siciliana - Assessorato alla Cooperazione, Commercio, Artigianato e Pesca - Dipartimento Pesca, con periodo di attività 2013 - 2015, si è concluso proprio con la realizzazione della struttura museale; l'Osservatorio è stato istituito dall'Assessorato del Territorio e dell'Ambiente della Regione Siciliana nell'ambito di un accordo quadro con ARPA, ISPRA e CNR. Grazie al progetto ORBS, docenti e allievi dell'Accademia di Belle Arti di Palermo e il personale CNR – IAS (ex IAMC) S. S. di Capo Granitola, hanno collaborato sinergicamente permettendo di realizzare delle azioni didattiche e creative di valore scientifico espresse con straordinaria forza e bellezza. Ricercatori e professori si sono confrontati al fine di combinare le proprie competenze riuscendo nel progetto ambizioso di coinvolgere e fondere i diversi ambiti scientifici sensibilizzando gli artisti ai temi della Biodiversità. Le opere prodotte, corredate da schede scientifiche, hanno oltre al valore artistico un aggiunto valore didattico. L'apertura della sezione espositiva dedicata alla diffusione e alla comunicazione della biodiversità rappresenta da un lato l'importante tappa conclusiva del progetto, dall'altro l'inizio di un percorso mirato alla diffusione della biodiversità verso il mondo giovanile, le scuole e per tutto il territorio. Questa strepitosa collaborazione "CNR – Accademia di Belle Arti di Palermo" conferma l'importanza e l'opportunità di unire arte e scienza per esaltare la percezione della ricerca scientifica da parte della comunità. La divulgazione della scienza è un'attività complessa e sicuramente necessita di competenze e attitudini multidisciplinari oltreché di motivazione ed entusiasmo. La comunicazione delle tematiche scientifiche, di per sé ardua nella traduzione al grande pubblico, grazie alla forza esplicativa dell'arte, diviene opportunità di riflessione, osservazione, confronto per le comunità di visitatori. Il coordinamento delle visite delle scuole di ogni ordine e grado, Enti Pubblici, Comunità Scientifica, Cariche Istituzionali, Delegazioni di Politici Italiani e Stranieri, Associazioni Culturali, Associazioni No-Profit di Volontariato, Associazioni di Promozione Sociale, Organizzazioni di Volontariato, Onlus, pubblico in generale, presso ORBS, è affidato al qualificato personale (tecnici, tecnologi e ricercatori) dell'IAS – CNR S. S. di Capo Granitola, che gestisce in prima persona i visitatori nel percorso didattico e promuove il valore della divulgazione scientifica perseguendo la terza missione degli Enti di Ricerca, attraverso l'applicazione diretta, la valorizzazione e l'impiego della conoscenza

Prevalence of unwillingness and uncertainty to vaccinate against COVID-19 in older people: a systematic review and meta-analysis

The coronavirus disease 2019 (COVID-19) has been shown to have more severe health outcomes in older people specifically in relation to mortality and disability. Vaccination seems to be efficacious and safe for preventing the negative consequences of COVID-19, but vaccine hesitancy seems to be high in older adults. We therefore aimed to investigate the prevalence of unwillingness and the uncertainty to vaccinate against COVID-19 in older people and the factors that can be associated with the unwillingness to vaccinate. For this work, we searched several databases until 18th June 2021 for studies reporting the prevalence of unwillingness and the uncertainty to vaccinate against COVID-19 in people aged >60 years. A meta-analysis of the prevalence, with the correspondent 95% confidence intervals (CIs), was proposed. Factors that can be associated with the unwillingness to vaccinate against COVID-19 were explored through multivariable analyses and reported as odds ratios (ORs). Among 662 papers initially screened, we included 15 studies for a total of 9753 older adults. The prevalence of unwillingness to vaccinate against COVID-19 in older people was 27.03% (95%CI: 15.10–38.95%), whilst the correspondent figure of uncertainty was 19.33% (95%CI: 12.28–26.39). The risk of being unvaccinated was significantly higher in Hispanics (OR=1.197; 95%CI: 1.010–1.418) and in case of low education (OR=1.678; 95%CI: 1.170–2.408) and low income (OR=1.287; 95%CI: 1.127–1.469). In conclusion, the hesitancy for COVID-19 vaccination is a relevant problem in older people, particularly in those with a low income, a low level of education, and in Hispanics living in the United States

Older People Hospitalized for COVID-19: Prognostic Role of Multidimensional Prognostic Index and Other Prognostic Scores

During the SARS-CoV-2 pandemic, frailty and patients’ poor outcomes seem to be closely related. However, there is no clear indication of the significance of this connection and the most adequate risk index in clinical practice. In this study, we compared a short version of MPI (multidimensional prognostic index) and other two prognostic scores for COVID-19 as potential predictors of poor patient outcomes. The patients were consecutively enrolled in the hospital of Palermo for COVID-19. The accuracy of Brief-MPI, 4C score and COVID-GRAM score in points was evaluated using the area under the curve (AUC) with 95% CI, taking mortality or sub-ICU admission as outcome. The study included 112 participants (mean age 77.6, 55.4% males). During a mean of 16 days of hospitalization, Brief-MPI significantly increased by 0.03 ± 0.14 (p = 0.04), whilst COVID-GRAM did not. Brief-MPI, 4C score and COVID-GRAM scores had good accuracy in predicting negative outcomes (AUC > 0.70 for all three scores). Brief-MPI was significantly associated with an increased mortality/ICU admission risk, indicating the importance of multidimensional impairment in clinical decision-making with an accuracy similar to other prognostic scores commonly used in COVID-19 study, providing information regarding domains for which interventions can be proposed

Targeting Cyclic Guanosine Monophosphate to Treat Heart Failure:JACC Review Topic of the Week

The significant morbidity and mortality associated with heart failure with reduced ejection fraction (HFrEF) or heart failure with preserved ejection fraction (HFpEF) justify the search for novel therapeutic agents. Reduced cyclic guanosine monophosphate levels contribute to HF progression. Among molecules modulating the nitric oxide (NO)-GMP-phosphodiesterase (PDE) pathway, the evaluation of nitrates, synthetic natriuretic peptides (NP), and NP analogs has yielded mixed results. Conversely, sacubitril/valsartan, combining NP degradation inhibition through neprilysin and angiotensin receptor blockade, has led to groundbreaking findings in HFrEF. Other strategies to increase tissue cyclic guanosine monophosphate have been attempted, such as PDE-3 or PDE-5 inhibition (with negative or neutral results), NO-independent soluble guanylate cyclase (sGC) activation, or enhancement of sGC sensitivity to endogenous NO. Following the positive results of the phase 3 VICTORIA (A Study of Vericiguat in Participants With Heart Failure With Reduced Ejection Fraction) trial on the sGC stimulator vericiguat in HFrEF, the main open questions are the efficacy of the sacubitril/valsartan-vericiguat combination in HFrEF and of vericiguat in HFpEF. (C) 2020 by the American College of Cardiology Foundation

Markers for the detection of Lewy body disease versus Alzheimer's disease in mild cognitive impairment: a systematic review and meta-analysis

No description supplied</p

Markers for the detection of Lewy body disease versus Alzheimer's disease in mild cognitive impairment: a systematic review and meta-analysis

No description supplied</p