Post-Telemedicine Acute Care for Undifferentiated High-Acuity Conditions: Is a Picture Worth a Thousand Words?

Telemedicine use increased substantially with the COVID-19 pandemic. Understanding of the impact of telemedicine modality (video vs. phone) on post-telemedicine acute care for higher risk conditions is limited.

Cytomegalovirus Infection in an Immunocompetent Host Presenting as Hemophagocytic Lymphohistiocytosis.

Unlabelled: Cytomegalovirus (CMV) is a human herpes virus with a worldwide seroprevalence of 60-100%, mainly known to cause severe life-threatening disease in immunocompromised patients. In immunocompetent hosts (IMCh), CMV causes a self-limiting mononucleosis-like infection, and severe pictures are less recognized. We report a case of a previously healthy 62-year-old woman evaluated in the Internal Medicine outpatient clinic for 3 weeks of progressive fatigue, generalised inflammatory arthralgias, hypogastric discomfort and daily persistent fever.

Raising awareness and addressing inequities for people with Down syndrome in South Africa.

Globally, individuals with Down syndrome (DS) face profound inequities in social and health care access. These challenges are further compounded by racial disparities as well as a lack of awareness, research, and support, particularly in the Global South. This commentary discusses the multifaceted challenges and disparities encountered by people with DS in South Africa, highlighting the need for targeted interventions.

Shaping current European mitochondrial haplogroup frequency in response to infection: the case of SARS-CoV-2 severity.

The frequency of mitochondrial DNA haplogroups (mtDNA-HG) in humans is known to be shaped by migration and repopulation. Mounting evidence indicates that mtDNA-HG are not phenotypically neutral, and selection may contribute to its distribution. Haplogroup H, the most abundant in Europe, improved survival in sepsis.

Deep learning-integrated MRI brain tumor analysis: feature extraction, segmentation, and Survival Prediction using Replicator and volumetric networks.

The most prevalent form of malignant tumors that originate in the brain are known as gliomas. In order to diagnose, treat, and identify risk factors, it is crucial to have precise and resilient segmentation of the tumors, along with an estimation of the patients' overall survival rate. Therefore, we have introduced a deep learning approach that employs a combination of MRI scans to accurately segment brain tumors and predict survival in patients with gliomas.

The environmental impact of inhalers: a framework for sustainable prescription practices in Spain.

Background: The healthcare sector contributes significantly to global greenhouse emissions, with inhalers being major contributors.

Objective: To develop a framework for reducing the environmental footprint of inhalers in Spain by implementing greener prescription practices.

Methods: A multidisciplinary working group was formed, including hospital pharmacists, pulmonologists, and environmental experts.

Neural network surrogate and projected gradient descent for fast and reliable finite element model calibration: A case study on an intervertebral disc.

Accurate calibration of finite element (FE) models is essential across various biomechanical applications, including human intervertebral discs (IVDs), to ensure their reliability and use in diagnosing and planning treatments. However, traditional calibration methods are computationally intensive, requiring iterative, derivative-free optimization algorithms that often take days to converge. This study addresses these challenges by introducing a novel, efficient, and effective calibration method demonstrated on a human L4-L5 IVD FE model as a case study using a neural network (NN) surrogate.

Superstable lipid vacuoles endow cartilage with its shape and biomechanics.

Conventionally, the size, shape, and biomechanics of cartilages are determined by their voluminous extracellular matrix. By contrast, we found that multiple murine cartilages consist of lipid-filled cells called lipochondrocytes. Despite resembling adipocytes, lipochondrocytes were molecularly distinct and produced lipids exclusively through de novo lipogenesis.

Clinical control in COPD and therapeutic implications: The EPOCONSUL audit.

Objective: This study aimed to evaluate clinical control in chronic obstructive pulmonary disease (COPD), the consequences in terms of treatment decisions, and their potentially associated factors during follow-up of patients in real-life clinical practice.

Methods: EPOCONSUL 2021 is a cross-sectional audit that evaluated the outpatient care provided to patients with a diagnosis of COPD in respiratory clinics in Spain and multivariable logistic regression models to assess the relationships between clinical control and clinical inertia.

Results: 4225 patients from 45 hospitals in Spain were audited.

Carbohydrate Ingestion Eliminates Hypoglycemia & Improves Endurance Exercise Performance in Triathletes Adapted to Very Low & High Carbohydrate Isocaloric Diets.

Very-low-carbohydrate diets (LCHF; <50g/day) have been debated for their potential to lower pre-exercise muscle and liver glycogen stores and metabolic efficiency, risking premature fatigue. It is also hypothesized that carbohydrate ingestion during prolonged exercise delays fatigue by increasing carbohydrate oxidation, thereby sparing muscle glycogen. Leveraging a randomized crossover design, we evaluated performance during strenuous time-to-exhaustion (70%⩒O) tests in trained triathletes following 6-week high-carbohydrate (HCLF, 380g/day) or very-low-carbohydrate (LCHF, 40g/day) diets to determine (i) if adoption of the LCHF diet impairs time-to-exhaustion performance, (ii) whether carbohydrate ingestion (10g/hour) 6-12x lower than current CHO fuelling recommendations during low glycogen availability (>15-hour pre-exercise overnight fast and/or LCHF diet) improves time-to-exhaustion by preventing exercise-induced hypoglycemia (EIH; <3.

Biomarkers.

Background: By 2025, an estimated three-quarters of the global population aged 60 and older will live in Latin American and Caribbean countries (LAC), leading to a rise in age-related conditions. The main goal of the Panama Aging Research Initiative - Health Disparities (PARI-HD) research program is to create a platform for multidisciplinary clinical studies that focus on mental health and its diseases such as age-related cognitive decline. This platform would generate a large amount of clinical, neuropsychological, lifestyle, genetic and biomarker data following standardized research protocols.

Biomarkers.

Background: There is an urgent need for accurate and validated methods to measure plasma phosphorylated tau (p-Tau) biomarkers in Alzheimer´s disease (AD). Here we compared the performance of newly developed plasma ALZpath p-Tau217 assay to other established p-Tau assays such as Lilly p-Tau217 and Lilly p-Tau181.

Method: We included 72 participants from the Arizona Study of Aging and Neurodegenerative Disorders cohort, where we analysed antemortem collected plasma samples with ALZpath p-Tau217 as well as Lilly p-Tau217 and p-Tau181.

Biomarkers.

Background: Accumulating evidence indicates that biological sex may influence clinical manifestation within the spectrum of frontotemporal lobar degeneration (FTLD), implying differences in cognitive reserve. Nonetheless, investigations into the impact of biological sex during the preclinical and minimally symptomatic stages of FTLD are lacking.

Method: We included 275 mutation carriers (158 females; 127 with C9orf72, 68 with GRN, and 80 with MAPT mutations) and 161 non-carrier familial controls (97 females) from the ALLFTD Consortium (Staffaroni et al.

Biomarkers.

Background: Dementia with Lewy bodies (DLB) is a an α-synucleinopathy characterized by dementia and a combination of parkinsonism, visual hallucinations, fluctuating cognition or REM sleep behaviour disorder. Specific biomarkers for DLB are lacking. DLB-related pattern (DLBRP) is a metabolic network imaging biomarker which expression can be quantified on a single patient basis.

Biomarkers.

Background: Bilingualism can stimulate brain plasticity (Jafari et al. Ann N Y Acad Sci. 2021;1505(1):8-22) and is also associated with better executive function (Grundy.

Biomarkers.

Background: Alzheimer's disease (AD) plasma biomarkers related to amyloid (A), tau (T), and neurodegeneration (N) can potentially be used to identify these pathological features of the disease, as shown in recent studies. Our objective was to compare the clinical and analytical performance of plasma AD biomarkers measured using the single-molecule array (Simoa) and Lumipulse platforms.

Method: We quantified ATN and AT plasma biomarkers in 127 patients with mild cognitive impairment (MCI) (n = 81), AD (n = 30), and non-AD dementia (n = 16) using a Simoa HD-1/HD-X analyser (Quanterix) and a Lumipulse G600II automated platform (Fujirebio Europe NV).

Biomarkers.

Background: We are conducting a biomarker-based study to describe the demographic and biomarker profiles of Panamanians. The objective of this report is to present the main findings on CSF, genetic and serological biomarkers' distribution and their association with cognition in a cohort of elderly people in Panama.

Method: Informed consent was applied to all participants, demographic data, medical history, and neuropsychological and functional status were collected, and non-fasting blood samples were obtained.

Biomarkers.

Background: Nearly all people with Down Syndrome (DS) develop Alzheimer's dementia (AD) by the 7 decade of life. However, whether the alterations in fluid biomarker levels associated with DS follow the same pattern to those observed in other forms of AD is not well understood.

Method: We used mass spectrometry-based proteomics to measure 1116 proteins in cerebrospinal fluid (CSF) across euploid controls (n=130), sporadic late-onset AD (LOAD, n=89), asymptomatic DS (n=117), prodromal DS (n=57), and dementia DS (n=80) cases, and compared the protein changes observed in DS to those in LOAD and to those recently described in autosomal dominant AD (ADAD).

Biomarkers.

Background: Cognitive resilience can be defined as better-than-expected cognitive performance in the context of Alzheimer's disease (AD) pathologies or increased AD risk. We investigated pathways associated with cognitive resilience trajectories in amyloid positive (A+) and/or APOE4 cognitively unimpaired (CU) older adults including brain resilience, resistance to AD pathologies and vascular pathology.

Method: We included 534 CU ADNI participants with available cognitive data, longitudinal amyloid-PET ( [F]florbetaben and [F]florbetapir) and structural MRI (gray matter volumes) and, as ubset with tau-PET ( [F]AV1451) (n = 287) and white matter hyperintensities (n = 467) volume data (n = 534).

Biomarkers.

Background: Individuals with Down Syndrome (DS) almost invariably develop Alzheimer's Disease (AD), but detecting early clinical changes is challenging due to comorbid intellectual disability, highlighting the importance of non-invasive biomarkers. Neuroimaging of the medial temporal lobe (MTL), a key site of tau pathology, shows promise as an early AD biomarker. Here, we aimed to characterise volumetric patterns of the MTL in DS across the AD clinical continuum, and define associations with AD cerebrospinal fluid (CSF) biomarkers.

Biomarkers.

Background: Alzheimer´s disease (AD) is the main cause of death in adults with Down syndrome (DS). We describe the unique contributions of the Down Alzheimer Barcelona Neuroimaging Initiative (DABNI) cohort by studying longitudinal changes in plasma and cerebrospinal fluid (CSF) markers.

Method: We included DABNI participants with DS that contributed at least two plasma and/or CSF samples and were asymptomatic (aDS, n=155), had prodromal AD (pDS, n=46) or had AD dementia (dDS; n=53) at baseline, together with 172 euploid cognitively normal controls (CN).

Biomarkers.

Background: Dementia, encompassing Alzheimer's disease (AD) and frontotemporal dementia (FTD), poses a substantial public health challenge in Latin America. Barriers such as a shortage of healthcare professionals, limited medical accessibility, and underdiagnosis contribute to the complexity. While biomarkers aligned with the ATN framework (Amyloid, Tau, Neurodegeneration) have revolutionized diagnosis, their cost limits adoption in Latin America.

Biomarkers.

Background: To date, limited data exist concerning the utility of FDG-PET in detecting Alzheimer's Disease (AD) in Down Syndrome (DS). Yet, sensitive biomarkers for neurodegeneration are essential in this population genetically predisposed for AD. Therefore, we aimed at characterizing the effect of age, disease stage and AD pathology on brain metabolism in a large cohort of adults with DS.