Contralateral Cerebro-Cerebellar White Matter Pathways for Verbal Working Memory: A Combined Diffusion Spectrum Imaging and fMRI Study

Diffusion spectrum imaging was employed to establish structural connectivity between cerebro-cerebellar regions co-activated during verbal working memory. IFG, IPL, pons, thalamus, superior cerebellum and inferior cerebellum were used as seed points to reconstruct the white matter cerebro-cerebellar circuitry. The reconstructed pathways were examined further to establish the relationship between structural and effective connectivity as well as the relationship between structural connectivity and verbal working memory performance. It was found that structural connectivity is indirectly related to effective connectivity but does not predict it. Additionally, it was demonstrated that the integrity of the ponto-cerebellar tract is an important factor in explaining individual differences in verbal working memory. The findings of the study furthered our understanding of the relationship between structural and functional connectivity and provided insight to the variability in verbal working memory performance

Cerebro-Cerebellar Pathways for Verbal Working Memory

open access articleThe current study examined the structural and functional connectivity of the cerebrocerebellar network of verbal working memory as proposed by Chen and Desmond (2005a). Diffusion spectrum imaging was employed to establish structural connectivity between cerebro-cerebellar regions co-activated during a verbal working memory task. The inferior frontal gyrus, inferior parietal lobule, pons, thalamus, superior cerebellum and inferior cerebellum were used as regions of interest to reconstruct and segment the contralateral white matter cerebro-cerebellar circuitry. The segmented pathways were examined further to establish the relationship between structural and effective connectivity as well as the relationship between structural connectivity and verbal working memory performance. No direct relationship between structural and effective connectivity was found but the results demonstrated that structural connectivity is indirectly related to effective connectivity as DCM models that resembled more closely with underlying white matter pathways had a higher degree of model inference confidence. Additionally, it was demonstrated that the structural connectivity of the ponto-cerebellar tract was associated with individual differences in response time for verbal working memory. The findings of the study contribute to further our understanding of the relationship between structural and functional connectivity and the impact of variability in verbal working memory performance

Esophageal dislodgment of a variceal ligator cap due to size mismatch between the ligator cap and the endoscope

10.1055/s-2003-37005Endoscopy352191ENDC

Longitudinal association of built environment pattern with DXA-derived body fat in elderly Hong Kong Chinese: A latent profile analysis.

BACKGROUND: One major limitation of prior studies regarding the associations between built environment (BE) and obesity has been the use of anthropometric indices (e.g., body mass index [BMI]) for assessing obesity status, and there has been limited evidence of associations between BE and body fat. This study aimed to explore the longitudinal association between BE and body fat in a cohort of elderly Hong Kong Chinese and examine whether the BE-body fat associations differed by BMI categories. METHODS: Between 2001 and 2003, 3944 participants aged 65-98 years were recruited and followed for a mean of 6.4 years. BE characteristics were assessed via Geographic Information System. Body fat (%) at whole body and regional areas (trunk, limbs, android, and gynoid) were assessed by dual energy X-ray absorptiometry at baseline and three follow-ups. Latent profile analysis was used to derive BE class, and linear mixed-effects models were used to investigate the associations of BE class with changes in body fat. Stratified analyses by BMI categories were also conducted. RESULTS: Three BE classes were identified. Participants in Class 2 (characterized by greater open space and proportion of residential land use) had a slower increase in whole body fat (B = -0.403, 95% confidence interval [CI]: -0.780, -0.014) and limbs fat (-0.471, 95% CI: -0.870, -0.071) compared with participants in Class 1 (characterized by high proportion of commercial land use). There were significant interactions of BE class with BMI, and participants in Class 2 had a slower increase in whole body fat and regional fat compared with participants in Class 1 (B ranging from -0.987 [limbs] to -0.523 [gynoid]) among overweight and obese participants only. CONCLUSIONS: We found that those who resided in the areas characterized by greater open space and proportion of residential land use had a slower body fat increase

Psychology at the National University of Singapore: The first 15 years

10.1111/1464-0597.00086Applied Psychology512181-20

Global perspective of familial hypercholesterolaemia: a cross-sectional study from the EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)

Background The European Atherosclerosis Society Familial Hypercholesterolaemia Studies Collaboration (FHSC) global registry provides a platform for the global surveillance of familial hypercholesterolaemia through harmonisation and pooling of multinational data. In this study, we aimed to characterise the adult population with heterozygous familial hypercholesterolaemia and described how it is detected and managed globally. Methods Using FHSC global registry data, we did a cross-sectional assessment of adults (aged 18 years or older) with a clinical or genetic diagnosis of probable or definite heterozygous familial hypercholesterolaemia at the time they were entered into the registries. Data were assessed overall and by WHO regions, sex, and index versus non-index cases. Findings Of the 61 612 individuals in the registry, 42 167 adults (21 999 [53·6%] women) from 56 countries were included in the study. Of these, 31 798 (75·4%) were diagnosed with the Dutch Lipid Clinic Network criteria, and 35 490 (84·2%) were from the WHO region of Europe. Median age of participants at entry in the registry was 46·2 years (IQR 34·3–58·0); median age at diagnosis of familial hypercholesterolaemia was 44·4 years (32·5–56·5), with 40·2% of participants younger than 40 years when diagnosed. Prevalence of cardiovascular risk factors increased progressively with age and varied by WHO region. Prevalence of coronary disease was 17·4% (2·1% for stroke and 5·2% for peripheral artery disease), increasing with concentrations of untreated LDL cholesterol, and was about two times lower in women than in men. Among patients receiving lipid-lowering medications, 16 803 (81·1%) were receiving statins and 3691 (21·2%) were on combination therapy, with greater use of more potent lipid-lowering medication in men than in women. Median LDL cholesterol was 5·43 mmol/L (IQR 4·32–6·72) among patients not taking lipid-lowering medications and 4·23 mmol/L (3·20–5·66) among those taking them. Among patients taking lipid-lowering medications, 2·7% had LDL cholesterol lower than 1·8 mmol/L; the use of combination therapy, particularly with three drugs and with proprotein convertase subtilisin–kexin type 9 inhibitors, was associated with a higher proportion and greater odds of having LDL cholesterol lower than 1·8 mmol/L. Compared with index cases, patients who were non-index cases were younger, with lower LDL cholesterol and lower prevalence of cardiovascular risk factors and cardiovascular diseases (all p<0·001). Interpretation Familial hypercholesterolaemia is diagnosed late. Guideline-recommended LDL cholesterol concentrations are infrequently achieved with single-drug therapy. Cardiovascular risk factors and presence of coronary disease were lower among non-index cases, who were diagnosed earlier. Earlier detection and greater use of combination therapies are required to reduce the global burden of familial hypercholesterolaemia. Funding Pfizer, Amgen, Merck Sharp & Dohme, Sanofi–Aventis, Daiichi Sankyo, and Regeneron

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien\u2013Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9\ub72 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4\u20137) and 7 (6\u20138) days respectively (P &lt; 0\ub7001). There were no significant differences in rates of readmission between these groups (6\ub76 versus 8\ub70 per cent; P = 0\ub7499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0\ub790, 95 per cent c.i. 0\ub755 to 1\ub746; P = 0\ub7659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34\ub77 versus 39\ub75 per cent; major 3\ub73 versus 3\ub74 per cent; P = 0\ub7110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients

Observation of Gravitational Waves from the Coalescence of a 2.5−4.5 M⊙2.5-4.5~M_\odot Compact Object and a Neutron Star

International audienceWe report the observation of a coalescing compact binary with component masses $2.5-4.5~M_\odot$ and $1.2-2.0~M_\odot$ (all measurements quoted at the 90% credible level). The gravitational-wave signal GW230529_181500 was observed during the fourth observing run of the LIGO-Virgo-KAGRA detector network on 2023 May 29 by the LIGO Livingston Observatory. The primary component of the source has a mass less than $5~M_\odot$ at 99% credibility. We cannot definitively determine from gravitational-wave data alone whether either component of the source is a neutron star or a black hole. However, given existing estimates of the maximum neutron star mass, we find the most probable interpretation of the source to be the coalescence of a neutron star with a black hole that has a mass between the most massive neutron stars and the least massive black holes observed in the Galaxy. We estimate a merger rate density of $55^{+127}_{-47}~\text{Gpc}^{-3}\,\text{yr}^{-1}$ for compact binary coalescences with properties similar to the source of GW230529_181500; assuming that the source is a neutron star-black hole merger, GW230529_181500-like sources constitute about 60% of the total merger rate inferred for neutron star-black hole coalescences. The discovery of this system implies an increase in the expected rate of neutron star-black hole mergers with electromagnetic counterparts and provides further evidence for compact objects existing within the purported lower mass gap