Concern on Skin Lightening Product Safety: Level of Awareness and Associated Factors Among Female Users in Bahir Dar City, Ethiopia.

Background: Most skin lightening products are composed of some toxic chemicals such as mercury and hydroquinone which are classified under critical ingredients which need evaluation. Consumption without sufficient awareness may lead to toxicities endangering skin health. Objective: The aim of this study was to assess the level of awareness towards the side effects of skin lightening products and associated factors among females in Bahir Dar city, Ethiopia. Methods: An institutional-based cross-sectional study design was conducted in Bahir Dar city from June 28 to August 28, 2022 among females that had been using skin whitening. Samples of 362 females were selected by using multistage sampling technique from selected drug retail outlets. The data was coded, cleaned, and analyzed by using SPSS version 26. The variables were analyzed through multiple regression in order to identify the associated factors towards the level of awareness on the side effects of skin lightening products. Results: Only 42.7% of the respondents had a favorable level of awareness. The highly influencing factors for using skin lightening products were peer pressure (39.9%) and social media (37.4%). Nearly half of the users experienced side effects. Only 8.9% of the respondents know the active ingredients of the products. Level of education was found to have significant association with level of awareness (AOR = 7.66, 95% CI: (1.23, 47.59); P = 0.029). Conclusion: Only less than half of women have favorable awareness towards skin lightening products they use. The significant association between educational level and level of awareness should be considered as an alternative intervention in addition to regulatory restrictions.

Consistency checks to improve measurement with the Personal and Social Performance Scale (PSP).

International Society for CNS Clinical Trials and Methodology convened an expert Working Group that assembled consistency/inconsistency flags for the Personal and Social Performance Scale (PSP). One hundred and forty seven flags were identified, 16 flag errors in deriving the PSP decile (i.e., total) score from the four individual domain scores, 74 flag inconsistencies between domain scores relative to Positive and Negative Symptom Scale (PANSS) item ratings and 57 flag inconsistencies between PSP decile score and PANSS items ratings. The flags were applied to assessments from randomized clinical trial data of antipsychotics in schizophrenia from almost 18,000 ratings. Twenty-two flags were raised in at least 5 of 1000 ratings. Nearly 20% of the PSP ratings had at least one inconsistency flag raised. Application of flags to clinical ratings may improve the reliability of ratings and validity of trials.

Relationship of contextual cueing and hippocampal volume in amnestic mild cognitive impairment patients and cognitively normal older adults.

There is currently some debate as to whether hippocampus mediates contextual cueing. In the present study, we examined contextual cueing in patients diagnosed with mild cognitive impairment (MCI) and healthy older adults, with the main goal of investigating the role of hippocampus in this form of learning. Amnestic MCI (aMCI) patients and healthy controls completed the contextual cueing task, in which they were asked to search for a target (a horizontal T) in an array of distractors (rotated L's). Unbeknownst to them, the spatial arrangement of elements on some displays was repeated thus making the configuration a contextual cue to the location of the target. In contrast, the configuration for novel displays was generated randomly on each trial. The difference in response times between repeated and novel configurations served as a measure of contextual learning. aMCI patients, as a group, were able to learn spatial contextual cues as well as healthy older adults. However, better learning on this task was associated with higher hippocampal volume, particularly in right hemisphere. Furthermore, contextual cueing performance was significantly associated with hippocampal volume, even after controlling for age and MCI status. These findings support the role of the hippocampus in learning of spatial contexts, and also suggest that the contextual cueing paradigm can be useful in detecting neuropathological changes associated with the hippocampus.

Resilient brain aging: characterization of discordance between Alzheimer's disease pathology and cognition.

BACKGROUND: Although it is now evident that normal cognition can occur despite significant AD pathology, few studies have attempted to characterize this discordance, or examine factors that may contribute to resilient brain aging in the setting of AD pathology. METHODS: More than 2,000 older persons underwent annual evaluation as part of participation in the Religious Orders Study or Rush Memory Aging Project. A total of 966 subjects who had brain autopsy and comprehensive cognitive testing proximate to death were analyzed. Resilience was quantified as a continuous measure using linear regression modeling, where global cognition was entered as a dependent variable and global pathology was an independent variable. Studentized residuals generated from the model represented the discordance between cognition and pathology, and served as measure of resilience. The relation of resilience index to known risk factors for AD and related variables was examined. RESULTS: Multivariate regression models that adjusted for demographic variables revealed significant associations for early life socioeconomic status, reading ability, APOE-ε4 status, and past cognitive activity. A stepwise regression model retained reading level (estimate = 0.10, SE = 0.02; p< 0.0001) and past cognitive activity (estimate = 0.27, SE = 0.09; p = 0.002), suggesting the potential mediating role of these variables for resilience. CONCLUSIONS: The construct of resilient brain aging can provide a framework for quantifying the discordance between cognition and pathology, and help identify factors that may mediate this relationship.

Cognitive and functional resilience despite molecular evidence of Alzheimer's disease pathology.

BACKGROUND: The correlation between neuropathological lesions and cognition is modest. Some individuals remain cognitively intact despite the presence of significant Alzheimer's disease (AD) pathology, whereas others manifest cognitive symptoms and dementia in the same context. The aim of the present study was to examine cognitive and cerebral reserve factors associated with resilient functioning in the setting of AD pathology. METHODS: University of Pennsylvania Alzheimer's Disease Center research participants with biochemical biomarker evidence of AD pathology (cerebrospinal fluid amyloid-ß1-42 <192 pg/mL) and comparable medial temporal lobe atrophy were categorized by Clinical Dementia Rating Scale-Sum of Boxes (CDR-SOB) score as AD dementia (CDR-SOB >1) or AD resilient (CDR-SOB ≤0.5). Groups were compared for a variety of demographic, clinical, and neuroimaging variables to identify factors that are associated with resilience to AD pathology. RESULTS: A univariate model identified education and intracranial volume (ICV) as significant covariates. In a multivariate model with backward selection procedure, ICV was retained as a factor most significantly associated with resilience. The interaction term between ICV and education was not significant, suggesting that larger cranial vault size is associated with resilience even in the absence of more education. CONCLUSIONS: Premorbid brain volume, as measured through ICV, provided protection against clinical manifestations of dementia despite evidence of significant accumulations of AD pathology. This finding provides support for the brain reserve hypothesis of resilience to AD.

Considerations in the design of clinical trials for cognitive aging.

What will it take to develop interventions for the treatment of age-related cognitive decline? Session V of the Summit provided perspectives on the design of clinical trials to evaluate promising but unproven interventions, and some of the steps needed to accelerate the discovery and evaluation of promising treatments. It considered strategies to further characterize the biological and cognitive changes associated with normal aging and their translation into the development of new treatments. It provided regulatory, scientific, and clinical perspectives about neurocognitive aging treatments, their potential benefits and risks, and the strategies and endpoints needed to evaluate them in the most rapid, rigorous, and clinically meaningful way. It considered lessons learned from the study of Alzheimer's disease, the promising roles of biomarkers in neurocognitive aging research, and ways to help galvanize the scientific study and treatment of neurocognitive aging.

Quality, and not just quantity, of education accounts for differences in psychometric performance between african americans and white non-hispanics with Alzheimer's disease.

The effect of race on cognitive test performance in the evaluation of Alzheimer's disease (AD) remains controversial. One factor that may contribute substantially to differences in cognitive test performance in diverse populations is education. The current study examined the extent to which quality of education, even after controlling for formal years of education, accounts for differences in cognitive performance between African Americans and White Non-Hispanics (WNHs). The retrospective cohort included 244 patients diagnosed with AD who self-identified as African Americans (n = 51) or WNHs (n = 193). The Wechsler Test of Adult Reading (WTAR) was used as an estimate of quality of education. In an analysis that controlled for traditional demographics, including age, sex, and years of formal education, African Americans scored significantly lower than WNHs on the Mini-Mental State Examination, as well as on neuropsychological tests of memory, attention, and language. However, after also adjusting for reading level, all previously observed differences were significantly attenuated. The attenuating effect remained even after controlling for disease severity, indicating that reading scores are not confounded by severity of dementia. These findings suggest that quality, and not just quantity, of education needs to be taken into account when assessing cognitive performance in African Americans with AD.

Successful aging: definitions and prediction of longevity and conversion to mild cognitive impairment.

OBJECTIVES: To examine alternative models of defining and characterizing successful aging. DESIGN: A retrospective cohort study. SETTING: Olmsted County, MN. PARTICIPANTS: Five hundred sixty community-dwelling nondemented adults, aged 65 years and older. MEASUREMENTS: Three models were developed. Each model examined subtests in four cognitive domains: memory, attention/executive function, language, and visuospatial skills. A composite domain score was generated for each of the four domains. In Model 1, a global z score was further generated from the four cognitive domains, and subjects with mean global z score in the top 10% were classified as "successful agers," whereas those in the remaining 90% were classified as "typical agers." In Model 2, subjects with all four domain scores above the 50th percentile were classified as "successful agers." In Model 3, a primary neuropsychological variable was selected from each domain, and subjects whose score remained above - 1 standard deviation compared with norms for young adults were labeled successful agers. Validation tests were conducted to determine the ability of each model to predict survival and conversion to mild cognitive impairment (MCI). RESULTS: Model 1 showed 65% lower mortality in successful agers compared with typical agers and also a 25% lower conversion rate to MCI. CONCLUSION: Model 1 was most strongly associated with longevity and cognitive decline; as such, it can be useful in investigating various predictors of successful aging, including plasma level, APOE genotype, and neuroimaging measurements.

The influence of apolipoprotein E genotype on visuospatial attention dissipates after age 80.

Although it is established that apolipoprotein E (APOE) e4 allele increases the risk of Alzheimer's disease (AD), epidemiological studies indicate that genetic risk decreases late in life. This raises the question of whether the effects of APOE on cognition that are seen in midlife arise from a cognitive phenotype of APOE or from the presence of early AD in some APOE-e4 carriers. The authors addressed this question by comparing the cognitive consequences of variation in the APOE gene between individuals over the age of 80 (old-old) and middle-aged and young-old individuals. A spatially cued discrimination paradigm--previously shown to be sensitive to AD and to APOE genotype--required a speeded categorization of a target letter following cues that were valid, invalid, or neutral in predicting target location. Results revealed greater costs of invalid cues in the APOE-e4 carriers of middle-aged and young-old, but not old-old, groups. The dissipation of the APOE effect in old-old individuals at lower risk of AD suggests that visuospatial attention impairments seen as early as midlife in APOE-e4 carriers may be a preclinical marker of AD.

Implicit learning of sequential regularities and spatial contexts in corticobasal syndrome.

The present study investigated two forms of implicit learning in patients with corticobasal syndrome (CBS): contextual cueing and sequence learning. The former primarily implicates the medial temporal lobe system, and the latter, fronto-striatal-cerebellar circuits. Results revealed relatively preserved contextual cueing in patients with CBS. By contrast, sequence learning showed impairments, which seemed to reflect inability to execute correct responses in the presence of intact learning of the sequence. These findings provide the first characterization of implicit learning systems in CBS, and show that the two systems are differentially affected in patients with CBS.

Neuropsychiatric features in 36 pathologically confirmed cases of corticobasal degeneration.

The authors investigated neuropsychiatric features in 36 pathologically confirmed cases of corticobasal syndrome. Depression, compulsive behavior, and frontal lobe-type behavioral alterations were noted in eight patients (22%). No patient experienced visual hallucinations. If confirmed by a prospective study, the absence of visual hallucinations may help to distinguish corticobasal syndrome from other parkinsonian syndromes.

Effects of ApoE genotype and mild cognitive impairment on implicit learning.

The goals were to investigate implicit learning in mild cognitive impairment (MCI), and to determine the relations of implicit learning systems to apolipoprotein E (ApoE) genotype in healthy controls. Elderly controls grouped by ApoE status (ApoE-e4 allele carriers versus ApoE-e4 allele non-carriers) and MCI patients participated in the study. Individuals in all three groups completed both contextual cueing and serial reaction time (SRT) tasks. In the former, people learn to use repeated spatial configurations to facilitate search for a target, whereas in the latter, they learn to use subtle sequence regularities to respond more quickly and accurately to a series of events. Results revealed that healthy elderly individuals carrying the ApoE-e4 allele showed contextual cueing deficits compared to those who did not carry the ApoE-e4 allele. Further, elderly controls carrying the ApoE-e4 allele revealed similar amounts of contextual cueing as the MCI group, while the non-carriers performed better. Sequence learning, by contrast, was uninfluenced by either MCI or by ApoE genotype in healthy controls. This study provides further support for the medial temporal lobe dysfunction and relative integrity of fronto-striatal systems in MCI, and indicates the influence of ApoE genotype on implicit learning even in healthy older individuals without cognitive impairment.

Intermanual transfer of procedural learning after extended practice of probabilistic sequences.

Previous studies using simple, repeating patterns have suggested that the knowledge gained in early sequence learning is not effector-specific in that it transfers to muscle groups other than those used during training. The current experiments extended these findings to transfer after extensive practice with probabilistic sequences using a task on which people fail to gain declarative knowledge of the regularity. Specifically, an alternating serial reaction time (ASRT) task was used in which predictable and unpredictable trials alternated. Participants responded for the first five sessions using their right hand, then switched to the left hand for the sixth session. Stimuli were spatial in the first experiment and nonspatial in the second. Significant near-perfect transfer of pattern knowledge was seen in both experiments, suggesting that muscle-specific information for either the fingers or the eyes cannot explain the observed learning.