Long-Term Effect of Intensive vs Standard Blood Pressure Control on Mild Cognitive Impairment and Probable Dementia in SPRINT.

Background And Objectives: The Systolic Blood Pressure Intervention Trial suggested that intensive lowering of systolic blood pressure (SBP) decreases the risk of developing dementia. However, an insufficient number of probable dementia cases stemming from the trial's early termination made results inconclusive. The goal of this study was to estimate the effect of intensive vs standard SBP lowering on the longer term incidence of cognitive impairment leveraging extended follow-up for cognitive status.

Longitudinal qualitative assessment of meaningful symptoms and relevance of WATCH-PD digital measures for people with early Parkinson's.

Background: Longitudinal qualitative data on what matters to people with Parkinson's disease are lacking and needed to guide patient-centered clinical care and development of outcome measures.

Objective: To evaluate change over time in symptoms, impacts, and relevance of digital measures to monitor disease progression in early Parkinson's.

Methods: In-depth, online symptom mapping interviews were conducted with 33 people with early Parkinson's at baseline and 1 year later to evaluate (A) symptoms, (B) impacts, and (C) relevance of digital measures to monitor personally relevant symptoms.

Alzheimer Disease Plasma Biomarkers in the Mid-Western Amish.

Introduction: Alzheimer disease (AD) plasma biomarkers are noninvasive measures of the key amyloid beta (Aβ) and tau pathologies. Validation and generalization studies are needed to fully understand their potential for AD prediction and diagnosis in the elderly population.

Methods: In 1,067 Amish individuals aged ≥ 65, we measured plasma Aβ and tau to assess their relationships with AD-related outcomes.

Fox Insight: Most Bothersome Symptoms in Early-Stage Parkinson's Disease.

Background: Limited evidence exists regarding the meaningfulness of symptoms experienced in early Parkinson's disease (PD).

Objectives: To identify the most bothersome symptoms experienced by people with early PD, leveraging data from the Parkinson's Disease Patient Report of Problems (PD-PROP) questionnaire within the Fox Insight Study.

Methods: Individuals with a self-reported diagnosis of PD completed the PD-PROP questionnaire, reporting up to five most bothersome symptoms.

Examination of MGMT as a risk gene for dementia in the Amish.

Introduction: Recently, the O-6-methylguanine-DNA methyltransferase (MGMT) locus was proposed as influencing the risk of Alzheimer's disease (AD) in women who did not carry the apolipoprotein E ε4 allele. We examined an Amish founder population for any influence of genetic variation in and around the MGMT locus on the risk for dementia.

Methods: Genetic association was performed for single nucleotide polymorphisms (SNPs) surrounding the MGMT locus.

Effects of a pre-weaning socialization system on piglet livability, lifetime growth performance, and subsequent sow performance.

A total of 3,307 (PIC L 42) sows and 55,160 piglets were used to determine the effects of different farrowing systems on piglet livability and lifetime growth performance. Treatments were assigned to farrowing rooms and consisted of a conventional farrowing system (sows and piglets housed in individual farrowing stalls) or a pre-weaning socialization system (stall dividers removed between farrowing stalls and walkways within 6 to 24 h post-farrowing such that 12 to 32 litters of piglets were co-mingled). A total of 40 farrowing rooms with 80 stalls each were used with 20 rooms per treatment.

Survival after extracorporeal cardiopulmonary resuscitation for adolescent arrhythmogenic arrest: ECPella (extracorporeal membrane oxygenation with Impella)-a case report.

Background: The combined therapy with venoarterial extracorporeal membrane oxygenation and Impella (ECPella) has been shown to improve survival in acute cardiogenic shock (CS) in adult patient. Only three paediatric cases have been reported in a multicentre study.

Case Summary: We present our case, the first described to our knowledge in the UK, of a 15-year-old adolescent of Afro-Caribbean descent, weight 75 kg, who received extracorporeal cardiopulmonary resuscitation (E-CPR) and ECPella implantation.

Pearls and Pitfalls of T1-Weighted Neuroimaging: A Primer for the Clinical Radiologist.

All T1-weighted images are built upon one of two fundamental pulse sequences, spin-echo and gradient echo, each of which has distinct signal characteristics and clinical applications. Moreover, within each broadly defined category of T1-weighting, acquisition parameters can be modified to affect image quality, contrast, and scan duration; each tailored sequence has unique advantages, drawbacks, clinical indications, and potential artifacts. In this review, we describe key features that distinguish different types of T1-weighted sequences and discuss the utility of each sequence for specific clinical settings, including neuro-oncology, vasculopathy, and pediatric neuroradiology.

Homeopathy for Rheumatological Diseases: A Systematic Review.

Homeopathy has mainly been used to treat several diseases. On the other hand, it has been used in a few rheumatic disorders. The aim of this article is to review the use of homeopathy in rheumatic diseases (RDs).

Measuring clinically relevant change in apathy symptoms in ADMET and ADMET 2.

Objectives: Among participants with Alzheimer's disease (AD) we estimated the minimal clinically important difference (MCID) in apathy symptom severity on three scales.

Design: Retrospective anchor- and distribution-based analyses of change in apathy symptom scores.

Setting: Apathy in Dementia Methylphenidate Trial (ADMET) and ADMET 2 randomized controlled trials conducted at three and ten clinics specialized in dementia care in United States and Canada, respectively.

Gliomas in adults: Guidance on investigations, diagnosis, treatment and surveillance.

Primary brain tumours are rare but carry a significant morbidity and mortality burden. Malignant gliomas are the most common subtype and their incidence is increasing within our ageing population. The diagnosis and treatment of gliomas involves substantial interplay between multiple specialties, including general medical physicians, radiologists, pathologists, surgeons, oncologists and allied health professionals.

Building expert consensus regarding sharing of individual research results in Alzheimer's disease research: a Delphi study protocol.

Introduction: Informed decisions to enrol in the clinical investigations of Alzheimer's disease and related dementias (ADRD) require careful consideration of complex risks and uncertain benefits. Decisions regarding whether to receive information about biomarker status are complicated by lack of scientific consensus regarding biomarkers as surrogate endpoints for Alzheimer's disease and how information about individual risk should be evaluated and shared with research participants. This study aims to establish stakeholder consensus regarding ethically optimal approaches to sharing individual results with ADRD research participants.

ECG and Atrial Appendage Doppler Discordance Is Common in Patients Undergoing Cardiac Surgery: Prospective Study.

Background: Patients with atrial fibrillation (AF) remain at increased risk of thromboembolism despite apparent maintenance of sinus rhythm with the cause often attributed to periods of asymptomatic AF. Atrial mechanical discordance, with the body of the left atrium (LA) in sinus rhythm and the left atrial appendage (LAA) in AF may also be a contributor.

Objectives: The purpose of this study was to assess the frequency of electrocardiogram (ECG) rhythm and LAA and/right atrial appendage (RAA) Doppler ejection phenotype (transesophageal echocardiography [TEE]) discordance in patients undergoing cardiac surgery.

Extraocular Muscle Enlargement in Thyroid Eye Disease Using Volumetric Analysis.

Background And Objectives: It is commonly taught that thyroid eye disease (TED) causes enlargement of the extraocular muscles (EOMs) in the following descending order: inferior rectus (IR), medial rectus (MR), superior rectus (SR), lateral rectus (LR), superior oblique (SO) and inferior oblique (IO). However, with recent literature challenging this notion, we aimed to compare EOM volumes in our cohort of TED patients.  Methods: We conducted a retrospective, non-randomized case-control study.

Understanding the impact of distance and disadvantage on lung cancer care and outcomes: a study protocol.

Background: Lung cancer is the third most common cancer in the UK and the leading cause of cancer mortality globally. NHS England guidance for optimum lung cancer care recommends management and treatment by a specialist team, with experts concentrated in one place, providing access to specialised diagnostic and treatment facilities. However, the complex and rapidly evolving diagnostic and treatment pathways for lung cancer, together with workforce limitations, make achieving this challenging.

mTORC1 activity oscillates throughout the cell cycle, promoting mitotic entry and differentially influencing autophagy induction.

Mechanistic Target of Rapamycin Complex 1 (mTORC1) is a master metabolic regulator that is active in nearly all proliferating eukaryotic cells; however, it is unclear whether mTORC1 activity changes throughout the cell cycle. We find that mTORC1 activity oscillates from lowest in mitosis/G1 to highest in S/G2. The interphase oscillation is mediated through the TSC complex but is independent of major known regulatory inputs, including Akt and Mek/Erk signaling.