Blood cancer journal

BACKGROUND: Gait impairments increase with advancing age and can lead to falls and loss of independence. Brain atrophy also occurs in older age and may contribute to gait decline. We aimed to investigate global and regional relationships of cerebral gray and white matter volumes with gait speed, and its determinants step length and cadence, in older people. METHODS: In a population-based study, participants aged >60 years without Parkinson's disease or brain infarcts underwent magnetic resonance imaging and gait measurements using a computerized walkway. Linear regression was used to study associations of total gray and white matter volumes with gait, adjusting for each other, age, sex, height and white matter hyperintensity volume. Other covariates considered in analyses included weight and vascular disease history. Voxel-based morphometry was used to study regional relationships of gray and white matter with gait. RESULTS: There were 305 participants, mean age 71.4 (6.9) years, 54% male, mean gait speed 1.16 (0.22) m/s. Smaller total gray matter volume was independently associated with poorer gait speed (p = 0.001) and step length (p<0.001), but not cadence. Smaller volumes of cortical and subcortical gray matter in bilateral regions important for motor control, vision, perception and memory were independently associated with slower gait speed and shorter steps. No global or regional associations were observed between white matter volume and gait independent of gray matter volume, white matter hyperintensity volume and other covariates. CONCLUSION: Smaller gray matter volume in bilaterally distributed brain networks serving motor control was associated with slower gait speed and step length, but not cadence

Mapping topography and network of brain injury in patients with disorders of consciousness

BackgroundThere is a growing interest in the topography of brain regions associated with disorders of consciousness. This has caused increased research output, yielding many publications investigating the topic with varying methodologies. The objective of this study was to ascertain the topographical regions of the brain most frequently associated with disorders of consciousness.MethodsWe performed a cross-sectional text-mining analysis of disorders of consciousness studies. A text mining algorithm built in the Python programming language searched documents for anatomical brain terminology. We reviewed primary PubMed studies between January 1st 2000 to 8th February 2023 for the search query “Disorders of Consciousness.” The frequency of brain regions mentioned in these articles was recorded, ranked, then built into a graphical network. Subgroup analysis was performed by evaluating the impact on our results if analyses were based on abstracts, full-texts, or topic-modeled groups (non-negative matrix factorization was used to create subgroups of each collection based on their key topics). Brain terms were ranked by their frequency and concordance was measured between subgroups. Graphical analysis was performed to explore relationships between the anatomical regions mentioned. The PageRank algorithm (used by Google to list search results in order of relevance) was used to determine global importance of the regions.ResultsThe PubMed search yielded 24,944 abstracts and 3,780 full texts. The topic-modeled subgroups contained 2015 abstracts and 283 full texts. Text Mining across all document groups concordantly ranked the thalamus the highest (Savage score = 11.716), followed by the precuneus (Savage score = 4.983), hippocampus (Savage score = 4.483). Graphical analysis had 5 clusters with the thalamus once again having the highest PageRank score (PageRank = 0.0344).ConclusionThe thalamus, precuneus and cingulate cortex are strongly associated with disorders of consciousness, likely due to the roles they play in maintaining awareness and involvement in the default mode network, respectively. The findings also suggest that other areas of the brain like the cerebellum, cuneus, amygdala and hippocampus also share connections to consciousness should be further investigated

Brain activation during memory encoding in type 2 diabetes mellitus:a discordant twin pair study

Type 2 diabetes mellitus increases the risk of dementia and neuronal dysfunction may occur years before perceptible cognitive decline. We aimed to study the impact of type 2 diabetes on brain activation during memory encoding in middle-aged people, controlling for age, sex, genes, and early-shared environment. Twenty-two twin pairs discordant for type 2 diabetes mellitus (mean age 60.9 years) without neurological disease were recruited from the Australian Twin Registry (ATR) and underwent functional magnetic resonance imaging (fMRI) during a memory encoding task, cognitive tests, and structural MRI. Type 2 diabetes was associated with significantly reduced activation in left hemisphere temporoparietal regions including angular gyrus, supramarginal gyrus, and middle temporal gyrus and significantly increased activation in bilateral posteriorly distributed regions. These findings were present in the absence of within-pair differences in standard cognitive test scores, brain volumes, or vascular lesion load. Differences in activation were more pronounced among monozygotic (MZ) pairs, with MZ individuals with diabetes also displaying greater frontal activation. These results provide evidence for preclinical memory-related neuronal dysfunction in type 2 diabetes. They support the search for modifiable later-life environmental factors or epigenetic mechanisms linking type 2 diabetes and cognitive decline

Stroke Severity and Comorbidity Index for Prediction of Mortality after Ischemic Stroke from the Virtual International Stroke Trials Archive-Acute Collaboration

M. Kaste on työryhmän VISTA-Acute Collaboration jäsen.Background: There is increasing interest in the use of administrative data (incorporating comorbidity index) and stroke severity score to predict ischemic stroke mortality. The aim of this study was to determine the optimal timing for the collection of stroke severity data and the minimum clinical dataset to be included in models of stroke mortality. To address these issues, we chose the Virtual International Stroke Trials Archive (VISTA), which contains National Institutes of Health Stroke Scale (NIHSS) on admission and at 24 hours, as well as outcome at 90 days. Methods: VISTA was searched for patients who had baseline and 24-hour NIHSS. Improvement in regression models was performed by the net reclassification improvement (NRI) method. Results: The clinical data among 5206 patients were mean age, 69 +/- 13; comorbidity index, 3.3 +/- .9; median NIHSS at baseline, 12 (interquartile range [IQR] 8-17); NIHSS at 24 hours, 9 (IQR 8-15); and death at 90 days in 15%. The baseline model consists of age, gender, and comorbidity index. Adding the baseline NIHSS to model 1 improved the NRI by 0.671 (95% confidence interval [CI] 0.595-0.747) [or 67.1% correct reclassification between model 1 and model 2]. Adding the 24 hour NIHSS term to model 1 (model 3) improved the NRI by 0.929 (95% CI 0.857-1.000) for model 3 versus model 1. Adding the variable thrombolysis to model 3 (model 4) improve NRI by 0.1 (95% CI 0.023-0.178) [model 4 versus model 3]. Conclusion: The optimal model for the prediction of mortality was achieved by adding the 24-hour NIHSS and thrombolysis to the baseline model.Peer reviewe

Stroke Severity Versus Dysphagia Screen as Driver for Post-stroke Pneumonia

Background and Purpose: Post-stroke pneumonia is a feared complication of stroke as it is associated with greater mortality and disability than in those without pneumonia. Patients are often kept “Nil By Mouth” (NBM) after stroke until after receiving a screen for dysphagia and declared safe to resume oral intake. We aimed to assess the proportional contribution of stroke severity and dysphagia screen to pneumonia by borrowing idea from coalition game theory on fair distribution of marginal profit (Shapley value).Method: Retrospective study of admissions to the stroke unit at Monash Medical Center in 2015. Seventy-five percent of data were partitioned into training set and the remainder (25%) into validation set. Variables associated with pneumonia (p &lt; 0.1) were entered into Shapley value regression and conditional decision tree analysis.Results: In 2015, there were 797 admissions and 617 patients with ischemic and hemorrhagic stroke (age 69.9 ± 16.2, male = 55.0%, National Institute of Health Stroke Scale/NIHSS 8.1 ± 7.9). The frequency of pneumonia was 6.6% (41/617). In univariable analyses NIHSS, time to dysphagia screen, Charlson comorbidity index (CCI), and age were significantly associated with pneumonia but not weekend admission. Shapley value regression showed that the largest contributor to the model was stroke severity (72.8%) followed by CCI (16.2%), dysphagia screen (3.8%), and age (7.2%). Decision tree analysis yielded an NIHSS threshold of 14 for classifying people with (27% of 75 patients) and without pneumonia (2.5% of 308 patients). The area under the ROC curve for training data was 0.83 (95% CI 0.75–0.91) with no detectable difference between the training and test data (p = 0.4). Results were similar when dysphagia was exchanged for the variable dysphagia screen.Conclusion: Stroke severity status, and not dysphagia or dysphagia screening contributed to the decision tree model of post stroke pneumonia. We cannot exclude the chance that using dysphagia screen in this cohort had minimized the impact of dysphagia on development of pneumonia

Seasonal variation of phytoplankton in My Thanh River, Mekong delta, Vietnam

A study on the seasonal variation of phytoplankton composition was conducted at the upper, middle, and lower parts of the My Thanh River, which supplies an important source of water for aquaculture. Qualitative and quantitative samples of phytoplankton were collected monthly at both high and low tide. The results showed that a total of 171 phytoplankton (algae) species were recorded, belonging to 59 genera and 5 phyla. Diatoms were the most abundant group with the highest species number, followed by green algae. The other phyla possessed a lower number of species. The species composition was more diverse in the rainy season and at high tide at most of the sampling sites. The mean density of algae varied from 30,900-43,521 ind.L^-1^. The density of diatoms was higher in the middle and lower parts. At the same time, euglenoids displayed the highest density in the upper part, showing a difference in the dominant algae group under the influence of salinity. Salinity was found to be significantly positively correlated (p<0.01) with diatoms, whereas it was negatively correlated (p<0.05) with blue-green algae and euglenoids. The algae composition was quite diverse, with the H' index ranging from 2.0-3.3, showing the water quality was slightly to moderately polluted

Untersuchungen zur Stabilisierung der frühen postnatalen Adaptationsvorgänge bei Kälbern in Mutterkuhhaltung - ein Beitrag zur Charakterisierung postnataler Anpassungsreaktionen

Ziel dieser Arbeit war es, die sensible Phase der ersten und frühen zweiten Adaptationsphase, von der Geburt bis zur 72. Lebensstunde, bei Kälbern fleischbetonter Rassen in einem geschlossenen Mutterkuhbestand zu untersuchen, um daraus folgend einen Beitrag zur Erstellung von nicht parametrischen Referenzbereichen für klinische und labordiagnostische Parameter für diese Zeitspanne zu leisten. Korrelationen zwischen klinischen und labordiagnostischen Parametern sollten aufgedeckt werden, um so klinisch relevante Beziehungen herstellen zu können Eine Einschätzung der Vitalität anhand leicht zu erhebender ethologischer Befunde, wie erstes Kopfheben post natum, erstes sicheres Stehen und erste Kolostrumaufnahme wurde durchgeführt. Als Probanden standen insgesamt 115 mature Kälber verschiedener Rassen aus einem geschlossenen Mutterkuhbestand zur Verfügung. Die Untersuchung erstreckte sich von der Geburt bis zu 72 Stunden p. n.. Folgende 20 Parameter kamen dabei zur Auswertung: pH, Base Excess, Kohlendioxidpartialdruck, Hä­¡tokrit, Gesamtprotein, Glukose, Triglyzeride, Cholesterin, Harnstoff, Kreatinin, Natrium, Kalium, Chlorid, Magnesium, AST, ALT, AP, GGT, GLDH und CK. Die statistische Auswertung der Ergebnisse wurde unter Berücksichtigung der Faktoren Alter, Rasse, Geschlecht und Geburtsart der Kälber sowie Geburtsziffer des Muttertieres vorgenommen. Die einzelnen Messgrössen bis auf das Plasmachlorid wurden über den Untersuchungszeitraum hochsignifikant (p < 0,001) durch das Alter beeinflusst. Einflí²í³¥ der Rasse zeigten sich im Verlauf des Blut-pH-Wertes (p <= 0,01), des Base Excess (p <= 0,05) sowie der Enzyme ALT (p <= 0,05) und GLDH (p <= 0,05). Das erste sichere Stehen post natum wurde schwach signifikant durch das Geschlecht (p <= 0,05) beeinflusst. Die Parameter pH-Wert (p <= 0,05) und Kohlendioxidpartialdruck (p <= 0,01) im venösen Blut sowie die Blutglukose (p <= 0,01) zeigten bis zum dritten Lebenstag ebenfalls Einflüsse durch das Geschlecht der Kälber. Die Geburtsart übte einen signifikanten Einfluss auf die ethologischen Parameter des ersten Stehens (p <= 0,01) und des ersten Saugens post natum (p <= 0,01) aus, die Einstufung nach APGAR wurde sogar hoch signifikant (p <= 0,001) durch die Geburtsart beeinflusst. Labordiagnostisch konnte ein signifikanter Einfluss auf die CK-Aktivität (p <= 0,01) ermittelt werden. pH-Wert, Kaliumkonzentration und AST-Aktivität erfuhren schwach signifikante (p <= 0,05) Beeinflussungen durch die Art der Geburt. Die Parität der Muttertiere, beeinflusste die Geburtsart signifikant (p <= 0,01). Ebenso wiesen die Serumspiegel des Gesamtproteins (p <= 0,05), von Harnstoff (p <= 0,01), Kalium (p <= 0,05), ALT (p <= 0,05) und GLDH (p <= 0,05) Einflüsse der die Geburtsziffer auf. Im Verlauf der AP-Aktivitäten zeigten sich hoch signifikante Wechselwirkungen (p <= 0,001) mit den verschiedenen Rassen. Das Geschlecht der Kälber wies ebenso hoch signifikante Wechselwirkungen (p <= 0,001) zur GLDH-Aktivität auf. Wechselwirkungen der Geburtsart und der Zeit waren bei den Messgrössen pH-Wert (p <= 0,001), Kohlendioxidpartialdruck (p <= 0,01), Base Excess (p <= 0,001), Hämatokrit (p <= 0,001), Harnstoff (p <= 0,05) und AST-Aktivität (p <= 0,05) statistisch nachweisbar. Auf die Parameter Harnstoff (p <= 0,001), Natrium (p <= 0,05), Kalium (p <= 0,05), Chlorid (p <= 0,05) und ALT-Aktivität (p <= 0,05) waren Wechselwirkungen der Geburtsziffer der Muttertiere von der Geburt bis zur 72. Lebensstunde darstellbar. Die Körpertemperatur der Kälber korrelierte unmittelbar nach der Geburt signifikant (p <= 0,01) mit dem Blut-pH-Wert (r = -0,283) und dem Kohlendioxidpartialdruck (r = +0,284). Zum Base Excess bestand postnatal eine schwach signifikante (p <= 0,05) Korrelation (r = -0,193). Die Blutglukosewerte korrelierten unmittelbar post natum schwach signifikant (p <= 0,05) mit dem Blut-pH (r = -0,207), dem Kohlendioxidpartialdruck (r = +0,089) und dem Base Excess (r = 0,210). Das erste Kopfheben post natum stand in hoch signifikantem (p <= 0,001) Zusammenhang mit der Vitalitätseinschätzung nach APGAR. Das erste Stehen zeigte einen signifikante (p <= 0,01) und der Zeitpunkt der ersten Kolostrumaufnahme noch einen schwach signifikanten (p <= 0,05) Zusammenhang. Zur exakten Einschätzung der labordiagnostisch ermittelten Blutwerte bei neugeborenen Kälbern ist eine vom genauen Alter abhängige Erstellung von Referenzbereichen unter Berücksichtigung nicht parametrischer Referenzbereiche notwendig.The aim of the present study was to illustrate the sensitive time of the first and the early second adaptation period from birth to the 72. hour of life in different races of beef cattle in one herd. Furthermore non parametric reference values for clinical and laboratory diagnostic parameters for this period of adaptation were described. Another aim was to find correlations between clinical and laboratory parameters to show relations of clinical relevance. Ethological findings such as: first raising of the head post natum, first firm standing and colostrum intake were evaluated. For tests, a total of 115 mature calves of different races out of a close suckler cow management system herd was available. The evaluation was made from immediately after birth to 72 hours p. n.. The following 20 parameters were evaluated: pH, base excess, carbondioxide partial pressure, hematocrit, total protein, glucose, triglyceride, cholesterol, uric acid, creatinin, sodium, calium, potassium, chloride, magnesium, AST, ALT, AP, GGT, GLDH and CK. When doing the statistical evaluation of the results factors such as: age, race, sex, kind of birth of the calves as well as the number of births given by the mother cow were considered. The development of the single values over the time period of the research was highly influenced by the age (p <= 0.001). Influence of the race was found during the course of the blood-pH-value (p <= 0.01), of the base excess (p <= 0.05) and also of the enzymes ALT (p <= 0.05) and GLDH (p <= 0.05). The time of first firm standing post natum as a qualifying factor was only weak significantly (p <= 0.05) influenced by the sex. The parameter blood-pH (p <= 0.05), blood glycose (p <= 0.01) and carbondioxide partial pressure (p <= 0.01) also proved influence of the sex of the calves during the first 3 days after birth. The kind of birth had a significant influence on the ethological parameter of the first standing (p <= 0.01) and the first suckling post natum (p <= 0.01). When judging according to APGAR the correlation was even highly significant (p <= 0.001). In the laboratory diagnostics a significant influence on the CK-activity (p <= 0.01) could be found. pH-value, potassium concentration and AST-activity were weak significantly influenced (p <= 0.05) by the kind of birth. The kind of birth was significantly influenced (p <= 0.01) by the fact how often a mother cow already had given birth to calves. The serum level of the total protein (p <= 0.05), of the uric acid (p <= 0.01), potassium (p <=0.05), ALT (p <= 0.05) and GLDH (p <= 0.05) also showed their correlation to the number of birth. During the course of the AP activities of the different races significant interactions became obvious (p <= 0.001). The sex of the calves also showed highly significant interactions (p <= 0.001) towards the GLDH activity. Interactions of the kind and time of birth could also statistically be proven for the parameters: pH value (p <= 0.001), carbondioxide partial pressure (p <= 0.01), base excess (p <= 0.001), hematocrit (p <= 0.001), uric acid (p <= 0.05) and AST activity (p <= 0.05). For the parameters uric acid (p <= 0.001), sodium (p <= 0.05), potassium (p <= 0.05), chloride (p <= 0.05) and AST activity (p <= 0.05), an interaction could be found to the number of births given by the mother cow from the date of birth till the 72nd hour after birth. Correlation was discovered between body temprature and blood glycose to pH, carbondioxide partial pressure and base excess. The body temperature of the calves correlated after birth directly and significantly (p <= 0.01) with the blood-pH-value (r = -0.283) and the carbondioxide partial pressure (r = +0.284). There existed a slightly significant (p <= 0.05) correlation (r = -0.193) to the base excess. The blood glycose values correlated directly post natum slightly significantly (p <= 0.05) with the blood-pH (r = -0.207) with the carbondioxide partial pressure (r = +0.089) and with the base excess (r = 0.210). The first raising of the head post natum was in a highly significant connection (p <= 0.001) with the judgement of the vitality by APGAR. The first standing up showed a significant (p <= 0.01) and the time of first intake of cholostrum still a weak significant (p <=0.05) correlation. For the exact evaluation of the blood values derived from laboratory diagnostics for newly born calves, a table with values referring to the exact age and also considering the non-parameter values must be created

Googling Boundaries for Operating Mobile Stroke Unit for Stroke Codes

Background: Mobile stroke units (MSU) have been proposed to expedite delivery of recombinant tissue plasminogen activator (tPA) and expedite endovascular clot retrieval (ECR). Unexplored questions in the use of MSU include: maximal distance from base, time limit with regards to the use CT imaging, CT Angiography, CT Perfusion, and Telemedicine. We developed a computational model as an app (https://gntem3.shinyapps.io/ambmc/), taking into account traveling time to explore this issue. The aim of this study was to define the operating parameters for an MSU in a large metropolitan city, based on the geography of Melbourne.Methods: There are 2 hospitals (Royal Melbourne Hospital/RMH, Monash Medical Center/MMC) designated to provide state-wide ECR services. In these spatial simulations, the MSU is based at RMH and delivers tPA at the patient's pick-up address and then takes the patient to the nearest ECR center. We extracted the geocode of suburbs in Melbourne and travel time to each hospital using ggmap, an interface to Google Map API. The app contains widgets for varying the processing time at the patient location (default = 30 min), performing CT angiography (default = 10 min), performing telemedicine consultation (default = 15 min). The data were compared against those for usual ambulance metrics (default traveling time = 15 min, processing time at patient's location = 20 min, door to tPA = 60 min, door to groin = 90 min). Varying the widgets allow the viewer to explore the trade-off between the variable of interest and time to therapy at a suburb level.Results: The MSU was superior for delivering tPA to all Melbourne suburbs (up to 76 min from RMH). If the CTA times or processing time at location increased by 20 min then it was superior for providing ECR to only 74.9% of suburbs if the return base was RMH. Addition of CT Perfusion or telemedicine consultation affect the ability of a single hospital to provide ECR but not tPA if these additions can be limited to 20 min. Conclusion: The app can help to define how best to deploy the MSU across Melbourne. This app can be modified and used to optimize operating characteristics of MSU in other centers around the world

Solid state crystal growth of single crystals of 0.75(Na1/2Bi1/2)TiO3-0.25SrTiO(3) and their characteristic electrical properties

Ceramics of composition 0.75(Na1/2Bi1/2)TiO3-0.25SrTiO(3) (NBT-25ST) show a giant electric field-induced strain, making them attractive for actuator applications. Single crystals generally have improved piezoelectric properties over their ceramic counterparts, but the electrical properties of NBT-25ST single crystals have not yet been studied. In this work, NBT-25ST single crystals are grown by the solid state crystal growth technique and their electrical properties measured for the first time. The single crystals show relaxor ferroelectric behavior typical of an NBT-type material. The ferroelectric and inverse piezoelectric properties depend strongly on crystallographic orientation, with superior properties in the (001) orientation. The inverse piezoelectric properties of the (001)-oriented NBT-25ST single crystal are superior to those of an NBT-25ST ceramic (S-max/E-max = 1042 pm/V vs. 739 pm/V)

Frailty is associated with cognitive decline independent of cerebral small vessel disease and brain atrophy

BACKGROUND: To examine the effect of frailty on cognitive decline independent of cerebral small vessel disease (cSVD) and brain atrophy, and whether associations between neuropathology and cognition differed depending on frailty status. METHODS: The Tasmanian Study of Cognition and Gait was a population-based longitudinal cohort study with data collected at 3 phases from 2005 to 2012. Participants aged 60-85 were randomly selected from the electoral roll. Various data were used to operationalize a 36-item frailty index (FI) at baseline. Brain MRI was undertaken to obtain baseline measures of neuropathology. A neuropsychological battery was used to assess cognition at each time point. Generalized linear mixed models were used to examine the effect of frailty and MRI measures on cognition over time. The associations between MRI measures and cognition were explored after stratifying the sample by baseline frailty status. All analyses were adjusted for age, sex, and education. RESULTS: A total of 385 participants were included at baseline. The mean age was 72.5 years (standard deviation [SD] 7.0), 44% were female (n = 171). In fully adjusted linear mixed models, frailty (FI × time β -0.001, 95% confidence interval [CI] -0.003, -0.001, p = .03) was associated with decline in global cognition, independent of brain atrophy, and cSVD. The association between cSVD and global cognition was significant only in those with low levels of frailty (p = .03). CONCLUSION: These findings suggest that frailty is an important factor in early cognitive dysfunction, and measuring frailty may prove useful to help identify future risk of cognitive decline