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1.
J Pers ; 2024 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-39072767

RESUMO

OBJECTIVE AND BACKGROUND: The goals of this project were to improve our understanding of chronic regulatory focus constructs and to provide researchers with a measure that adequately assesses the constructs, can distinguish individual differences effectively across the range of the constructs, and is appropriate for use in diverse populations. METHOD: Employing best practices in construct validation, we developed the International Personality Item Pool Regulatory Focus Scale (IPIP-RFS). Utilizing 14 samples (N = 4867), we established substantive (via expert ratings and regulatory focus literature), structural (via factor analysis, item response theory, and measurement invariance), and external (via convergent, discriminant, and predictive associations) validity. RESULTS: The IPIP-RFS adequately assesses the constructs of chronic promotion focus and prevention focus, can accurately assess individuals along the continua of the constructs, and is suitable for use among populations that vary in gender, race, and age. Individual differences in promotion focus reflect self-regulation and goal pursuit related to cognitive and behavioral exploration and flexibility (i.e., plasticity), whereas individual differences in prevention focus reflect self-regulation and goal pursuit related to motivational and interpersonal steadiness (i.e., stability). CONCLUSIONS: Promotion and prevention focus are important elements of personality with broad implications for functioning and outcomes in health and other important domains.

2.
Sci Rep ; 14(1): 17146, 2024 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-39060380

RESUMO

Endophytic fungi are widely known as fungi that infect internal tissues of host plants for all or part of their life cycles, without causing visible symptoms of disease. The present study was carried out to identify and investigate the pathogenicity of endophytic fungi residing in husks, silks, and kernels of corn. Endophytic fungi were isolated from surface-sterilised silks, kernels, and husks of healthy corn plants and identified using sequencing of multiple markers comprising TEF-1α, ß-tubulin, calmodulin, ITS, LSU, and ACT. A total of 56 isolates of endophytic fungi belonging to 17 species, namely Fusarium pseudocircinatum (n = 8), F. verticillioides (n = 2), F. andiyazi (n = 4), F. sacchari (n = 1), F. mangiferae (n = 1), F. fujikuroi (n = 1), F. proliferatum (n = 3), F. incarnatum (n = 2), Penicillium oxalicum (n = 2), P. polonicum (n = 2), P. citrinum (n = 11), Aspergillus flavus (n = 10), A. tubingensis (n = 1), Cladosporium tenuissimum (n = 3), Aureobasidium pullulans (n = 3), Curvularia lunata (n = 1), and Epicoccum sorghinum (n = 1) were identified. Pathogenicity test showed that all endophytic fungi induced varying severities of disease symptoms on corn plants such as leaf chlorosis and necrosis, stem malformation, wilt, and stunted growth with F. verticillioides being the most virulent. The study revealed that corn tissues harbour diverse genera of endophytic fungi that can infect corn plants and may cause harmful effects to the host plants.


Assuntos
Endófitos , Doenças das Plantas , Zea mays , Zea mays/microbiologia , Endófitos/genética , Endófitos/isolamento & purificação , Endófitos/patogenicidade , Doenças das Plantas/microbiologia , Fungos/patogenicidade , Fungos/isolamento & purificação , Fungos/genética , Fungos/classificação , Filogenia , Fusarium/patogenicidade , Fusarium/genética , Fusarium/isolamento & purificação , Virulência
3.
Blood Adv ; 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38954844

RESUMO

Serial prophylactic exchange blood transfusion (SPEBT) is increasingly used in pregnant women with sickle cell disease (SCD), despite a lack of robust evidence. TAPS2 (Transfusion Antenatally in Pregnant Women with Sickle Cell Disease) study assessed the feasibility and acceptability of conducting a definitive randomized controlled trial of SPEBT (intervention) versus standard care (control) in pregnant women with SCD. Women ≥18 years with SCD, between 6+0 and 18+0 weeks of singleton gestation, were randomized 1:1 to control or intervention every 6-10 weeks throughout pregnancy in seven hospitals in England. The main outcomes evaluated were recruitment rate (primary outcome), acceptability, and retention. Secondary outcomes were safety, maternal and infant clinical outcomes. 194 women were screened over 42 months (extended due to the pandemic), 88 were eligible, and 35 (39.8%) consented to participate. Eighteen participants were randomized to intervention and 17 to control. Follow-up data were collected on all participants. Twelve patients in the intervention group received at least one SPEBT, of these, 11 received  3. The remaining patient was withdrawn from SPEBT due to transfusion reaction. Sixteen control participants required at least one transfusion. There were no statistically significant differences in terms of maternal, infant, or postnatal outcomes. A trend towards a lower incidence of vaso-occlusive crisis, preterm delivery and improved birthweight was observed in the intervention group. Despite the pandemic, this study achieved satisfactory recruitment and retention, confirming its acceptability to participants. TAPS2 demonstrates that it is feasible to perform a definitive international trial of SPEBT in pregnant women with SCD. Trial registration: NIH registry (www.clinicaltrials.gov), registration number NCT03975894 (registered 05/06/19); ISRCTN (www.isrctn.com), registration number ISRCTN52684446 (retrospectively registered 02/08/19). TAPS2 trial Protocol: available at https://rdcu.be/drlwc.

5.
PLoS One ; 19(7): e0288895, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38976697

RESUMO

To assess whether biomarkers of systemic inflammation are associated with HIV acquisition or with the timing of ART initiation ("immediate", at diagnosis, versus "deferred", at 24 weeks post-diagnosis) in men-who-have-sex-with-men (MSM) and transgender women, we conducted a retrospective study comparing inflammatory biomarkers in participants' specimens collected before infection and after ≥2 years of effective ART. We measured biomarkers in four longitudinally collected plasma, including two specimens collected from each participant before and two after HIV acquisition and confirmed ART-suppression. Biomarkers were quantified by enzyme-linked immuno-assay or Meso Scale Discovery. When evaluating systematic variation in these markers over time, we found that multiple biomarkers consistently varied across participants' two pre-infection or two post-ART-suppression specimens. Additionally, we compared changes in biomarkers after vs before HIV acquisition. Across 47 participants, the levels of C-reactive protein (CRP), monocyte chemo-attractant protein-1, tumor necrosis factor-α and interferon gamma-induced protein-10 significantly increased while leptin and lipopolysaccharide binding protein (LBP) significantly decreased following HIV infection. Randomization to deferred-ART initiation was associated with greater increases in CRP and no decrease in LBP. Acquisition of HIV appeared to induce systemic inflammation, with elevation of biomarkers previously associated with infections and cardiovascular disease. Initiation of ART during the early weeks of infection tempered the increase in pro-inflammatory biomarkers compared to delaying ART for ~24 weeks after HIV diagnosis. These findings provide insight into potential mediators by which immediate-ART initiation improves health outcomes, perhaps because immediate-ART limits the size of the HIV reservoir or limits immune dysregulation that in turn trigger systemic inflammation.


Assuntos
Biomarcadores , Infecções por HIV , Humanos , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , Infecções por HIV/sangue , Masculino , Biomarcadores/sangue , Feminino , Adulto , Estudos Retrospectivos , Inflamação/sangue , Pessoa de Meia-Idade , Proteínas de Fase Aguda/metabolismo , Proteína C-Reativa/metabolismo , Proteína C-Reativa/análise , Fármacos Anti-HIV/uso terapêutico , Pessoas Transgênero , Proteínas de Transporte , Glicoproteínas de Membrana
6.
Artigo em Inglês | MEDLINE | ID: mdl-39004836

RESUMO

STUDY DESIGN: Retrospective review of a single institution cohort. OBJECTIVE: To determine whether Area Deprivation Index (ADI) or Social Vulnerability Index (SVI) is more suitable for evaluating minimum clinically important difference (MCID) achievement following elective lumbar fusion as captured by the Patient Reported Outcomes Measurement Information System (PROMIS). SUMMARY OF BACKGROUND DATA: A total of 182 patients who underwent elective one- to two-level posterior lumbar fusion between January 2015 and September 2021. METHODS: ADI and SVI values were calculated from patient-supplied addresses. Patients were grouped into quartiles based on values; higher quartiles represented greater disadvantage. MCID thresholds for Pain Interference (PI) and Physical Function (PF) were determined via a distribution-based method. Multivariable logistic regression was performed to identify factors impacting MCID attainment. Univariate logistic regression was performed to determine which themes comprising SVI values affected MCID achievement. Statistical significance was set at P<0.05. RESULTS: Multivariate logistic regression demonstrated that ADI and SVI quartile assignment significantly impacted achievement of MCID for PI (P=0.04 and P=0.01 respectively) and PF (P=0.03 and P=0.02 respectively). Specifically, assignment to the third ADI and SVI quartiles were significant for PI (OR: 0.39 and 0.23 respectively), and PF (OR: 0.24 and 0.22 respectively). Race was not a significant predictor of MCID for either PI or PF. Univariate logistic regression demonstrated that among SVI themes, the socioeconomic status theme significantly affected achievement of MCID for PI (P=0.01), while the housing type and transportation theme significantly affected achievement of MCID for PF (P=0.01). CONCLUSION: ADI and SVI quartile assignment were predictors of MCID achievement. While ADI and SVI may both identify patients at risk for adverse outcomes following lumbar fusion, SVI offers greater granularity in terms of isolating themes of disadvantage impacting MCID achievement.

8.
Arch Dis Child ; 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38977298

RESUMO

OBJECTIVE: To compare immunological responses of preterm infants to a four-component meningococcal B vaccine (4CMenB; Bexsero) following a 2+1 vs a 3+1 schedule, and to describe reactogenicity of routine vaccines. DESIGN: An open-label, phase IV randomised study conducted across six UK sites. SETTING: Neonatal units, postnatal wards, community recruitment following discharge. PARTICIPANTS: 129 preterm infants born at a gestation of <35 weeks (64 in group 1 (2+1), 65 in group 2 (3+1)) were included in the analysis. Analysis was completed for postprimary samples from 125 participants (59 in group 1, 66 in group 2) and for postbooster samples from 118 participants (59 in both groups). INTERVENTIONS: Infants randomised to 4CMenB according to a 2+1 or a 3+1 schedule, alongside routine vaccines. MAIN OUTCOME MEASURES: Serum bactericidal antibody (SBA) assays performed at 5, 12 and 13 months of age: geometric mean titres (GMTs) and proportions of infants achieving titres ≥4 compared between groups. RESULTS: There were no significant differences in SBA GMTs between infants receiving a 2+1 compared with a 3+1 schedule following primary or booster vaccination, but a significantly higher proportion of infants had an SBA titre ≥4 against strain NZ98/254 (porin A) at 1 month after primary vaccination using a 3+1 compared with a 2+1 schedule (3+1: 87% (95% CI 76 to 94%), 2+1: 70% (95% CI 56 to 81%), p=0.03).At 12 weeks of age those in the 3+1 group, who received a dose of 4CMenB, had significantly more episodes of fever >38.0°C than those in the 2+1 group who did not (group 2+1: 2% (n=1); 3+1: 14% (n=9); p=0.02). CONCLUSIONS: Both schedules were immunogenic in preterm infants, although a lower response against strain NZ98/254 was seen in the 2+1 schedule; ongoing disease surveillance is important in understanding the clinical significance of this difference. TRIAL REGISTRATION NUMBER: NCT03125616.

9.
Microbiol Spectr ; : e0085624, 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38980016

RESUMO

Escherichia coli is excreted in high numbers from the intestinal tract of humans, other mammals, and birds. Traditionally, it had been thought that E. coli could grow only within human or animal hosts and would perish in the environment. Therefore, the presence of E. coli in water has become universally accepted as a key water quality indicator of fecal pollution. However, recent research challenges the assumption that the presence of E. coli in water is always an indicator of fecal contamination, with some types of E. coli having evolved to survive and grow in aquatic environments. These strains can form blooms in water storages, resulting in high E. coli counts even without fecal contamination. Although these bloom-forming strains lack virulence genes and pose little threat to public health, their presence in treated water triggers the same response as fecal-derived E. coli. Yet, little is known about the effectiveness of treatment processes in removing or inactivating them. This study evaluated the effectiveness of current treatment processes to remove bloom-forming strains, in comparison to fecal-derived strains, with conventional coagulation-flocculation-sedimentation and filtration investigated. Second, the effectiveness of current disinfection processes-chlorination, chloramination, and ultraviolet (UV) light to disinfect bloom-forming strains in comparison to fecal-derived strains-was assessed. These experiments showed that the responses of bloom isolates were not significantly different from those of fecal E. coli strains. Therefore, commonly used water treatment and disinfection processes are effective to remove bloom-forming E. coli strains from water.IMPORTANCEThe presence of Escherichia coli in water has long been used globally as a key indicator of fecal pollution and for quantifying water safety. Traditionally, it was believed that E. coli could only thrive within hosts and would perish outside, making its presence in water indicative of fecal contamination. However, recent research has unveiled strains of E. coli capable of surviving and proliferating in aquatic environments, forming blooms even in the absence of fecal contamination. While these bloom-forming strains lack the genes to be pathogenic, their detection in source or drinking water triggers the same response as fecal-derived E. coli. Yet, little is known about the efficacy of treatment processes in removing them. This study evaluated the effectiveness of conventional treatment and disinfection processes in removing bloom-forming strains compared to fecal-derived strains. Results indicate that these commonly used processes are equally effective against both types of E. coli, reassuring that bloom-forming E. coli strains can be eliminated from water.

12.
Int J Obes (Lond) ; 2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-39048696

RESUMO

BACKGROUND/OBJECTIVES: Maternal obesity is associated with a decreased intention and initiation of breastfeeding as well as a shortened duration of breastfeeding. This analysis was undertaken to identify breastfeeding behaviours, and relationships with maternal anthropometry and the serum metabolome at 6-months postpartum in an ethnically diverse cohort of women with obesity. SUBJECTS/METHODS: A cohort analysis of 715 women from the UK Pregnancies Better Eating and Activity Trial (UPBEAT); a multi-centre randomised controlled trial of an antenatal lifestyle intervention in women with obesity. Maternal data were collected in early pregnancy and included body mass index (BMI), socio-demographic characteristics and anthropometry. At 6-months postpartum, breastfeeding behaviours, anthropometry and 158 maternal metabolic measures from blood samples were recorded. Kaplan-Meier curves of breastfeeding duration were constructed and were stratified by obesity class (I: BMI 30.0-34.9 kg/m2, II: 35.0-39.9 kg/m2, III: ≥40.0 kg/m2). Relationships between breastfeeding behaviours, socio-demographic characteristics, the metabolome, and anthropometry were determined using regression analyses. RESULTS: Eighty-two percent (591/715) of the cohort-initiated breastfeeding and at the 6-month follow-up 40% (283/715) were breastfeeding exclusively or partially. Duration of exclusive breastfeeding decreased with increasing BMI: Compared to BMI class I (mean 90.4 ± 64 days) the difference in mean for classes II and III were -15.8 days (95% confidence interval: -28.5, -3.1, p < 0.05) and -16.7 (95% CI: -32.0 to -1.35, p < 0.05), respectively. Compared to no breastfeeding, any breastfeeding at 6-months postpartum was associated with improvements in metabolites towards a healthier profile, reduced weight retention by -1.81 kg (95% CI -0.75, -2.88, p < 0.05 ) and reduced anthropometric measures, including mid-upper arm and hip circumferences. The breastfeeding related changes in anthropometry were not evident in women of Black ethnicity. CONCLUSIONS: Greater emphasis on enabling breastfeeding for women with obesity could improve duration, women's weight management and metabolic health. The lack of breastfeeding related anthropometric effects in Black women requires further investigation. CLINICAL TRIAL REGISTRY: ISRCTN reference 89971375.

13.
Nat Metab ; 2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-39048801

RESUMO

Microglia are necessary for central nervous system (CNS) function during development and play roles in ageing, Alzheimer's disease and the response to demyelinating injury1-5. The mitochondrial respiratory chain (RC) is necessary for conventional T cell proliferation6 and macrophage-dependent immune responses7-10. However, whether mitochondrial RC is essential for microglia proliferation or function is not known. We conditionally deleted the mitochondrial complex III subunit Uqcrfs1 (Rieske iron-sulfur polypeptide 1) in the microglia of adult mice to assess the requirement of microglial RC for survival, proliferation and adult CNS function in vivo. Notably, mitochondrial RC function was not required for survival or proliferation of microglia in vivo. RNA sequencing analysis showed that loss of RC function in microglia caused changes in gene expression distinct from aged or disease-associated microglia. Microglia-specific loss of mitochondrial RC function is not sufficient to induce cognitive decline. Amyloid-ß plaque coverage decreased and microglial interaction with amyloid-ß plaques increased in the hippocampus of 5xFAD mice with mitochondrial RC-deficient microglia. Microglia-specific loss of mitochondrial RC function did impair remyelination following an acute, reversible demyelinating event. Thus, mitochondrial respiration in microglia is dispensable for proliferation but is essential to maintain a proper response to CNS demyelinating injury.

14.
Energy Fuels ; 38(14): 12810-12823, 2024 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-39050490

RESUMO

Supercritical water liquefaction of different plastic wastes has been investigated under high-temperature and high-pressure conditions. The supercritical water liquefaction of commonly used plastic types, comprising polystyrene (PS), polypropylene (PP), and low-density polyethylene (LDPE) as well as their mixtures, is reported. The experiments were carried out at varying feedstock-to-water ratios with a residence time of 60 min under supercritical water reaction conditions. The process produced high oil yields of over 97 wt %, with the highest yields obtained at a plastic:water ratio of 1:3; at higher levels of input water, the yield of oil decreased slightly. The gas phase mainly consisted of light hydrocarbons such as methane, ethane, propane, and butane, with propane found to be the most abundant gas component. Aromatic hydrocarbons and alicyclic hydrocarbons were the major products in the product oil from the supercritical water liquefaction of polystyrene and polypropylene, whereas alkanes were predominant in the oil obtained from LDPE. Analysis of the oil obtained from binary (1:1) and ternary (1:1:1) plastic mixtures showed it exhibited aromatic hydrocarbons as the major constituent, indicating synergistic interaction. It was found that the incorporation of PP in the mixture facilitated the production of cyclic compounds and suppressed the production of alkanes. Supercritical water liquefaction offers an effective solution to plastic pollution, producing valuable products without the need for catalysts.

15.
Sci Total Environ ; 948: 174671, 2024 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-39004368

RESUMO

The widespread and excessive use of pesticides in modern agricultural practices has caused pesticide contamination of the environment, animals, and humans, with confirmed serious health consequences. This study aimed to identify the 20 most critical substances based on an analysis of detection frequency (DF) and median concentrations (MC) across environmental and biological matrices. A sampling campaign was conducted across 10 case study sites in Europe and 1 in Argentina, each encompassing conventional and organic farming systems. We analysed 209 active substances in a total of 4609 samples. All substances ranked among the 20 most critical were detected in silicon wristbands worn by humans and animals and indoor dust from both farming systems. Five of them were detected in all environmental matrices. Overall, higher values of DF and MC, including in the blood plasma of animals and humans, were recorded in samples of conventional compared to organic farms. The differences between farming systems were greater in the environmental samples and less in animal and human samples. Ten substances were detected in animal blood plasma from conventional farms and eight in animal blood plasma from organic farms. Two of those, detected in both farming systems, are classified as hazardous for mammals (acute). Five substances detected in animal blood plasma from organic farms and seven detected in animal blood plasma from conventional farms are classified as hazardous for mammals (dietary). Three substances detected in human blood plasma are classified as carcinogens. Seven of the substances detected in human blood plasma are classified as endocrine disruptors. Six substances, of which five were detected in human blood plasma, are hazardous for reproduction/development. Efforts are needed to elucidate the unknown effects of mixtures, and it is crucial that such research also considers biocides and banned substances, which constitute a baseline of contamination that adds to the effect of substances used in agriculture.

16.
OTO Open ; 8(3): e163, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38974175

RESUMO

Objective: Evaluate the quality of responses from Chat Generative Pre-Trained Transformer (ChatGPT) models compared to the answers for "Frequently Asked Questions" (FAQs) from the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Clinical Practice Guidelines (CPG) for Ménière's disease (MD). Study Design: Comparative analysis. Setting: The AAO-HNS CPG for MD includes FAQs that clinicians can give to patients for MD-related questions. The ability of ChatGPT to properly educate patients regarding MD is unknown. Methods: ChatGPT-3.5 and 4.0 were each prompted with 16 questions from the MD FAQs. Each response was rated in terms of (1) comprehensiveness, (2) extensiveness, (3) presence of misleading information, and (4) quality of resources. Readability was assessed using Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease Score (FRES). Results: ChatGPT-3.5 was comprehensive in 5 responses whereas ChatGPT-4.0 was comprehensive in 9 (31.3% vs 56.3%, P = .2852). ChatGPT-3.5 and 4.0 were extensive in all responses (P = 1.0000). ChatGPT-3.5 was misleading in 5 responses whereas ChatGPT-4.0 was misleading in 3 (31.3% vs 18.75%, P = .6851). ChatGPT-3.5 had quality resources in 10 responses whereas ChatGPT-4.0 had quality resources in 16 (62.5% vs 100%, P = .0177). AAO-HNS CPG FRES (62.4 ± 16.6) demonstrated an appropriate readability score of at least 60, while both ChatGPT-3.5 (39.1 ± 7.3) and 4.0 (42.8 ± 8.5) failed to meet this standard. All platforms had FKGL means that exceeded the recommended level of 6 or lower. Conclusion: While ChatGPT-4.0 had significantly better resource reporting, both models have room for improvement in being more comprehensive, more readable, and less misleading for patients.

17.
Learn Individ Differ ; 1092024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38962323

RESUMO

Math and reading skills are known to be related, and predictors of each are well researched. What is less understood is the extent to which these predictors, uniquely and collectively, overlap with one another, are differentially important for different academic skills, and account for the overlap of math and reading. We examined 20 potential predictors from four domains (working memory, processing speed, attention, and language) using latent variables and both timed and untimed achievement skill, in a sample (N=212) of at-risk middle schoolers, half of whom were English learners. The predictors accounted for about half of the overlap among achievement skills, suggesting that other factors (e.g., domain specific skills) might also be relevant for the overlap. We also found some differential prediction (language for reading, working memory for math). The present results extend and refine our understanding of the contribution of these cognitive predictors for reading and math.

18.
RSC Adv ; 14(31): 22504-22512, 2024 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-39021455

RESUMO

A nanostructured hybrid material based on mesoporous silica nanoparticles (MCM-41) functionalized with chitosan and a fluorescent dye (dansylglycine), designated MCM-41@Ch@DnsGly, was synthesized and characterized with a view to its application for the visualization of latent fingerprints. These nanoparticles were applied as latent fingerprint developers for marks on surfaces of diverse chemical composition, topography, optical characteristics, and spatially variant nature, typical of forensically challenging evidence. For quality assessment of the enhanced fingermarks, the developed images were analyzed holistically using the UK Home Office scale, forensic protocols and, in terms of their constituent features (minutiae), using forensic software. Across a substantive collection of marks deposited on chemically diverse surfaces and subject to complex environmental and temporal histories, 94% of the enhanced images presented sufficient minutiae for comparison with model dactyloscopy images. This novel nanomaterial presents enhanced performance with significant promise for superior exploitation by forensic practitioners in the acquisition and analysis of crime scene evidence.

19.
Parkinsonism Relat Disord ; 124: 107016, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38838453

RESUMO

BACKGROUND: We recently identified three distinct Parkinson's disease subtypes: "motor only" (predominant motor deficits with intact cognition and psychiatric function); "psychiatric & motor" (prominent psychiatric symptoms and moderate motor deficits); "cognitive & motor" (cognitive and motor deficits). OBJECTIVE: We used an independent cohort to replicate and assess reliability of these Parkinson's disease subtypes. METHODS: We tested our original subtype classification with an independent cohort (N = 100) of Parkinson's disease participants without dementia and the same comprehensive evaluations assessing motor, cognitive, and psychiatric function. Next, we combined the original (N = 162) and replication (N = 100) datasets to test the classification model with the full combined dataset (N = 262). We also generated 10 random split-half samples of the combined dataset to establish the reliability of the subtype classifications. Latent class analyses were applied to the replication, combined, and split-half samples to determine subtype classification. RESULTS: First, LCA supported the three-class solution - Motor Only, Psychiatric & Motor, and Cognitive & Motor- in the replication sample. Next, using the larger, combined sample, LCA again supported the three subtype groups, with the emergence of a potential fourth group defined by more severe motor deficits. Finally, split-half analyses showed that the three-class model also had the best fit in 13/20 (65%) split-half samples; two-class and four-class solutions provided the best model fit in five (25%) and two (10%) split-half replications, respectively. CONCLUSIONS: These results support the reproducibility and reliability of the Parkinson's disease behavioral subtypes of motor only, psychiatric & motor, and cognitive & motor groups.


Assuntos
Doença de Parkinson , Humanos , Doença de Parkinson/classificação , Doença de Parkinson/fisiopatologia , Doença de Parkinson/diagnóstico , Feminino , Masculino , Reprodutibilidade dos Testes , Idoso , Pessoa de Meia-Idade , Estudos de Coortes , Transtornos Mentais/classificação , Transtornos Mentais/diagnóstico , Transtornos Mentais/etiologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/classificação , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/diagnóstico
20.
Ophthalmol Sci ; 4(5): 100513, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38840779

RESUMO

Purpose: To describe a pilot study on the use of single-session, high-dose-rate, Food and Drug Administration-cleared, yttrium-90 (Y90) plaque brachytherapy for iris and iridociliary melanoma. Design: A single-center, clinical case series. Participants: Six consecutive patients were included in this study. Each was diagnosed with an iris or iridociliary melanoma based on clinical examination with or without biopsy. Methods: Each tumor was staged according to the American Joint Committee on Cancer criteria and received Y90 eye plaque brachytherapy. The main variables were tumor size, patient age, sex, and method of diagnosis (clinical or biopsy). Surgical techniques, treatment durations, and ocular side effects were recorded. Local control was defined as a lack of tumor growth or regression determined by clinical examinations, including slit-lamp and gonio photography, as well as high-frequency ultrasound measurements. Toxicity parameters included acute and short-term corneal/scleral change, anterior segment inflammation, and cataract progression. Main Outcome Measures: Local and systemic cancer control, tumor regression, visual acuity, as well as radiation-related normal tissue toxicity. Results: High-dose-rate Y90 plaque brachytherapy was used to treat small (American Joint Committee on Cancer cT1) category melanomas. Single-surgery high-dose-rate irradiations were performed under anesthesia. Because of short treatment durations, high-dose-rate Y90 did not require the additional procedures used for low-dose-rate plaque (e.g., sutures, amniotic membrane epicorneal buffering, Gunderson flaps, and second surgeries for plaque removal). Only conjunctival recession was used to avoid normal tissue irradiation. High-dose-rate Y90 treatment durations averaged 8.8 minutes (median, 7.9; range, 5.8-12.9). High-dose-rate Y90 brachytherapy was associated with no periorbital, corneal (Descemet folds), or conjunctival edema. There was no acute or short-term anterior uveitis, secondary cataract, scleropathy, radiation retinopathy, maculopathy, or optic neuropathy. The follow-up was a mean of 16.0 (range 12-24) months. Evidence of local control included a lack of expansion of tumor borders (n = 6, 100%), darkening with or without atrophy of the tumor surface (n = 5/6, 83%), and a mean 24.5% reduction in ultrasonographically measured tumor thickness. There were no cases of metastatic disease. Conclusions: High-dose-rate Y90 brachytherapy allowed for single-surgery, minimally invasive, outpatient irradiation of iris and iridociliary melanomas. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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