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1.
J Neurol Sci ; 466: 123232, 2024 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-39298972

RESUMEN

INTRODUCTION: We evaluated the relationship between baseline enlarged perivascular space (ePVS) burden and later cognitive decline. METHODS: 83 community-dwelling, older adults (aged 56-86) completed three annual cognitive assessments that included the Clinical Dementia Rating (CDR®) Dementia Staging Instrument Sum of Boxes (CDR-SB) and composite measures of executive function and episodic memory. An MRI scan at baseline was used to count ePVS in the basal ganglia and centrum semiovale. Mixed effects models were run with ePVS as the predictor variable and cognitive measures as the dependent variable. Covariates included age, sex, education, cerebral small vessel disease (cSVD) risk factors, and cSVD neuroimaging biomarkers. RESULTS: At baseline, high basal ganglia ePVS counts were associated with lower executive function scores and episodic memory scores. Moreover, baseline basal ganglia ePVS predicted worse longitudinal CDR-SB scores over the study period. DISCUSSION: Basal ganglia ePVS burden is a promising biomarker for cSVD-related cognitive and functional decline.

2.
Arch Math Log ; 63(7-8): 773-812, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39281188

RESUMEN

For a free filter F on ω , endow the space N F = ω ∪ { p F } , where p F ∉ ω , with the topology in which every element of ω is isolated whereas all open neighborhoods of p F are of the form A ∪ { p F } for A ∈ F . Spaces of the form N F constitute the class of the simplest non-discrete Tychonoff spaces. The aim of this paper is to study them in the context of the celebrated Josefson-Nissenzweig theorem from Banach space theory. We prove, e.g., that, for a filter F, the space N F carries a sequence ⟨ µ n : n ∈ ω ⟩ of normalized finitely supported signed measures such that µ n ( f ) → 0 for every bounded continuous real-valued function f on N F if and only if F ∗ ≤ K Z , that is, the dual ideal F ∗ is Katetov below the asymptotic density ideal Z . Consequently, we get that if F ∗ ≤ K Z , then: (1) if X is a Tychonoff space and N F is homeomorphic to a subspace of X, then the space C p ∗ ( X ) of bounded continuous real-valued functions on X contains a complemented copy of the space c 0 endowed with the pointwise topology, (2) if K is a compact Hausdorff space and N F is homeomorphic to a subspace of K, then the Banach space C(K) of continuous real-valued functions on K is not a Grothendieck space. The latter result generalizes the well-known fact stating that if a compact Hausdorff space K contains a non-trivial convergent sequence, then the space C(K) is not Grothendieck.

3.
Heliyon ; 10(17): e37412, 2024 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-39296057

RESUMEN

Objectives: Spread through air spaces (STAS) is a form of lung cancer invasion that extends beyond the tumor edge and is associated with a worse prognosis. Recent advances in immunotherapy highlight the importance of understanding the tumor microenvironment. This study aimed to investigate the prognostic significance of immune-cell distribution in lung cancer, focusing on the association with STAS. Materials and methods: We retrospectively analyzed 283 patients who underwent curative-intent lung resection for primary lung cancer. Multiplex immunofluorescence staining/phenotyping was performed on tissue microarrays to assess the distribution of CD4, CD8, CD20, CD68, and FoxP3 immune cells within the center and tumor edge. We defined the delta-Edge value (Δ) as the difference in the number of immune cells between the tumor edge and center. Recurrence-free probability (RFP) was analyzed using Kaplan-Meier and Cox proportional hazard models. Results: High ΔCD4 and ΔCD8 values were significantly associated with worse RFP. In stage I adenocarcinoma patients, STAS, and high ΔCD8 were independent risk factors for recurrence. Effect modification analysis revealed that high ΔFoxP3 was significantly associated with worse RFP in patients with STAS, but not in those without STAS. Patients with STAS and high Δimmune cell values had the lowest RFP among all groups. Conclusion: Immune-cell distribution, particularly CD4, CD8, and FoxP3, is a crucial prognostic factor in lung cancer. STAS and specific immune cell distribution patterns can be used to further stratify patient prognosis. Understanding these interactions may provide insights into potential therapeutic targets for personalized lung cancer treatment.

4.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 41(4): 715-723, 2024 Aug 25.
Artículo en Chino | MEDLINE | ID: mdl-39218597

RESUMEN

Animal localization and trajectory tracking are of great value for the study of brain spatial cognition and navigation neural mechanisms. However, traditional optical lens video positioning techniques are limited in their scope due to factors such as camera perspective. For pigeons with excellent spatial cognition and navigation abilities, based on the beacon positioning technology, a three-dimensional (3D) trajectory positioning and tracking method suitable for large indoor spaces was proposed, and the corresponding positioning principle and hardware structure were provided. The results of in vitro and in vivo experiments showed that the system could achieve centimeter-level positioning and trajectory tracking of pigeons in a space of 360 cm × 200 cm × 245 cm. Compared with traditional optical lens video positioning techniques, this system has the advantages of large space, high precision, and high response speed. It not only helps to study the neural mechanisms of pigeon 3D spatial cognition and navigation, but also has high reference value for trajectory tracking of other animals.


Asunto(s)
Columbidae , Navegación Espacial , Columbidae/fisiología , Animales , Navegación Espacial/fisiología , Imagenología Tridimensional , Grabación en Video , Cognición
5.
J Atheroscler Thromb ; 2024 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-39231653

RESUMEN

AIM: To determine whether the severity of cerebral small vessel disease (SVD) is associated with prehospital delay in acute ischemic stroke. METHODS: Consecutive patients with ischemic stroke were included in this study. We evaluated the SVD burden using the total SVD score. Patients were divided into 2 groups: onset-to-door time within 4.5 hours (early arrival group) and onset-to-door time over 4.5 hours (delayed arrival group). First, we assessed whether the total SVD score was related to prehospital delay using a logistic regression analysis. Second, we assessed which item of the score was independently associated with delays. Finally, we determined whether the item had a linear association with the delay. RESULTS: Of the 2,112 screened patients, 1,754 were enrolled in the study (1,253 males [71%]; median age, 69 years). There were 1,105 patients (63%) in the delayed arrival group. The total SVD score was independently associated with delay (OR 1.11, 95% CI 1.01-1.21, p=0.025). Among the 4 items of the score, only enlarged perivascular spaces (EPVS) in the basal ganglia was independently associated with delay (OR 1.37, 95% CI 1.05-1.80, p=0.022). A linear trend was observed between EPVS grade and delay with reference to EPVS grade 0-1 (EPVS grade 2: OR 1.22, 95% CI 0.92-1.62, p=0.170, EPVS grade 3: OR 1.69, 95% CI 1.20-2.38, p=0.002, EPVS grade 4: OR 2.17, 95% CI 1.37-3.44, p=0.001). CONCLUSIONS: Prehospital delay in acute ischemic stroke could be associated with the severity of SVD, particularly EPVS in the basal ganglia.

6.
Mem Cognit ; 2024 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-39231854

RESUMEN

Metaphors, such as lawyers are sharks, are seemingly incomprehensible when reversed (i.e. sharks are lawyers). For this reason, Kintsch (Psychonomic Bulletin & Review, 7(2), 257-266, 2000) argued that computational models of metaphor processing need to account for the non-reversibility of metaphors, and demonstrated success with his computational model, the "predication algorithm," in simulating metaphor comprehension in a way that is consistent with human cognition. Predication is an ostensibly directional algorithm because its equation is asymmetric such that semantic properties of the vehicle (e.g., sharks) are added to the topic (e.g., lawyers) rather than vice versa. Although predication has been accepted as a viable algorithm for simulating metaphor processing, one of its core assumptions - that the semantic processing of metaphor is directional - has not been systematically tested, nor has it been systematically tested against multiple rival algorithms in simulating metaphor comprehension. To that end, we tested the predication algorithm's performance and that of a set of rival algorithms in simulating metaphor comprehension and distinguishing between canonical (e.g., lawyers are sharks) and reversed (e.g., sharks are lawyers) metaphors. Our findings indicate (1) the predication algorithm is comparable to simpler, rival algorithms in simulating metaphor comprehension, and (2) despite the beliefs about the directionality of the predication algorithm, it produces surprisingly similar simulations for canonical metaphors and their topic-vehicle reversals. These findings argue against predication, at least as implemented in Kintsch's (2000) algorithm, as a viable model of metaphor processing. Implications for computational and psycholinguistic approaches to metaphor are discussed.

7.
Health Place ; 90: 103173, 2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-39276755

RESUMEN

This study examines the complex interplay between social and spatial structures among older adults, emphasizing the interest in considering the social composition of activity spaces and the spatial characteristics of social networks. There is a growing interest in the collection and analysis of both social and daily mobility spatial information to better understand people-place interactions and determinants of health. Yet, few analyses have explored how the social and spatial dimensions of people's lives relate. In this exploratory study, we analyze how social and spatial indicators collected with the VERITAS-Social questionnaire among 98 older adults in Montréal, Canada, relate, using confirmatory principal component analysis. The aim of the article is to provide empirical evidence on the reduction of dimensions of measures related to social networks, activity spaces, and combined socio-spatial structures.

8.
Sci Rep ; 14(1): 21253, 2024 09 11.
Artículo en Inglés | MEDLINE | ID: mdl-39261521

RESUMEN

This study evaluates the applicability of three thermal comfort indices-Physiologically Equivalent Temperature (PET), Standard Effective Temperature (SET), and Universal Thermal Climate Index (UTCI)-in various outdoor environments on the campus of Xi'an University, China. Meteorological data were collected on sunny days using a portable weather station at a height of 1.5 m, and subjective questionnaires were administered to 25 healthy university students over three months to gather Thermal Sensation Votes (TSV) and Thermal Comfort Votes (TCV). The study was conducted at four distinct outdoor locations: a lakeside area (Location 1), a shaded path (Location 2), a sports field (Location 3), and a plaza (Location 4). PET, SET, and UTCI values were calculated from the collected data using Rayman software. The analysis revealed significant differences in thermal comfort across the four locations, with the highest proportion of subjects feeling hot at the sports field (54.4%) and the highest proportion feeling cold at the lakeside (39%). The shaded path had the highest proportion of subjects feeling comfortable (79.4%), while the lakeside had the lowest (60.1%). The results indicated that SET underestimated thermal sensation at Locations 1, 3, and 4, necessitating calibration. PET was suitable for Locations 2, 3, and 4 but failed to reflect the thermal sensation at Location 1 due to prolonged sun exposure. In contrast, UTCI demonstrated applicability across all locations. To enhance accuracy, revised indices SET' and PET' were formulated using the mean-median method, providing more precise thermal comfort assessments. These findings underscore the limitations of SET and PET under specific conditions and highlight the robustness of UTCI, offering valuable insights for urban planning and design aimed at improving outdoor thermal comfort and well-being.


Asunto(s)
Sensación Térmica , Humanos , Universidades , Masculino , Femenino , Adulto Joven , Sensación Térmica/fisiología , Estudiantes , Temperatura , Adulto , China , Encuestas y Cuestionarios
10.
Open Res Eur ; 4: 136, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39219788

RESUMEN

This paper presents the approach adopted by the EGI-ACE project for the setup and delivery of Data Spaces for various scientific domains. The work was implemented by members of the EGI e-infrastructure and of several European Research Infrastructures in the context of the European Open Science Cloud programme. Our results are several Data Space services that enable the reuse and exploitation of open, scientific big data for compute intensive use cases. The paper illustrates the EGI-ACE approach through two examples: (1) EMSO ERIC Data Portal for seafloor and water column research and (2) ENES Data Space for climate research.


The EGI-ACE project created a number of Data Spaces for various scientific domains, allowing for easy access and reuse of open, scientific big data for compute intensive use cases. The aim of the European Commission's strategy for data is to create a common European Data Space, which will bring together relevant data infrastructures and governance frameworks to facilitate data sharing while ensuring control for individuals and companies generating the data. The Data Spaces created within EGI-ACE contribute towards achieving this goal, publishing curated data from international scientific communities 'in the cloud' and offering them for scalable exploitation and reuse through domain-specific tools and environments that offer data visualization, analysis, and mapping. The paper provides an overview of the technical and policy implementation approaches of the EGI-ACE Data Spaces and their potential future role in the single market for data in Europe. The paper presents the generic approach that EGI-ACE followed for the implementation of scientific data spaces, and illustrates this with two examples, one from climate sciences (ENES), one from marine sciences (EMSO).

11.
Neural Netw ; 180: 106702, 2024 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-39250872

RESUMEN

This paper derives the optimal rate of approximation for Korobov functions with deep neural networks in the high dimensional hypercube with respect to Lp-norms and H1-norm. Our approximation bounds are non-asymptotic in both the width and depth of the networks. The obtained approximation rates demonstrate a remarkable super-convergence feature, improving the existing convergence rates of neural networks that are continuous function approximators. Finally, using a VC-dimension argument, we show that the established rates are near-optimal.

12.
J Family Med Prim Care ; 13(8): 3106-3110, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39228607

RESUMEN

Introduction: The winter climate in Delhi is severe, with temperatures dropping below 10°C. As a result, individuals often resort to utilizing diverse heat sources such as electrical heating appliances, coal and gas geysers. Unfortunately, these sources are commonly associated with the emission of carbon monoxide (CO) which can accumulate in inadequately ventilated spaces. Exposure to this noxious gas can lead to acute lethargy and debilitation, leaving individuals in a state of helpless distress. Materials and Methods: The present study utilized a retrospective descriptive analysis to examine cases of fatal carbon monoxide exposure retrieved from the Department of Forensic Medicine archives at the esteemed All India Institute of Medical Sciences, New Delhi. Autopsy records were thoroughly examined with respect to various parameters including age, gender, seasonality of the incident, circumstances surrounding the death, source of carbon monoxide generation, post mortem observations, as well as toxicological analysis reports. Results and Discussion: This study entailed an analysis of 56 individuals who fell victim to carbon monoxide poisoning, with a staggering 95% of fatalities occurring during the winter season. The majority of the individuals affected belonged to the age bracket of 21-30 years. The most common sources of carbon monoxide exposure were linked to the use of coal-burning earthen or iron vessels for room heating, as well as structural fires. With the exception of one case, all incidents were accidental in nature. Additionally, nearly all of the victims were discovered in enclosed spaces with heating equipment in close proximity, and evidence of a struggle was noted on the crime scene or with the deceased. Conclusion: The findings of this study indicate that the principal contributor to the inadvertent build-up of lethal concentrations of carbon monoxide gas is the utilization of heating appliances within inadequately ventilated, enclosed spaces. Due to the scentless and non-irritating properties of this gas, individuals who are asleep may be unable to detect its presence in their surroundings, thereby leading to a silent death. To mitigate such risks, the installation of carbon monoxide detectors is crucial. Additionally, it is of utmost importance to raise public awareness regarding the perils associated with using fire pots, coal burning and electrical heating appliances in areas with insufficient ventilation.

13.
Contemp Jew ; 44(2): 281-298, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39239527

RESUMEN

In October 2017, Vienna's Leopoldstadt community succeeded in reinstalling a Hebrew street sign in a public space of the second district. This achievement became possible in large part due to the efforts of an active online community that encouraged many people to share their wish to have visible signs of the former historic Jewish quarter in the present urban space. Through vigorous Facebook and other social media activities, the interest that the group generated put pressure on the city, leading to the support of an art project. The placement of the Hebrew street sign marked a hybrid way of constructing Jewish urban spaces. The dialogue between virtual and physical spaces added new layers to the historic Jewish quarter of Vienna; this way of relational space making is, I wish to argue, paradigmatic for today's Europe as it witnesses the heyday of Holocaust tourism and klezmer revivals. In this article, I investigate this space-making process in Jewish public history in present Vienna and examine how the virtual community frames the way urban Jewish spaces are constructed.

14.
Front Aging Neurosci ; 16: 1457405, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39267720

RESUMEN

Purpose: Studying perivascular spaces (PVSs) is important for understanding the pathogenesis and pathological changes of neurological disorders. Although some methods for automated segmentation of PVSs have been proposed, most of them were based on 7T MR images that were majorly acquired in healthy young people. Notably, 7T MR imaging is rarely used in clinical practice. Herein, we propose a deep-learning-based method that enables automatic segmentation of PVSs on T2-weighted 3T MR images. Method: Twenty patients with Parkinson's disease (age range, 42-79 years) participated in this study. Specifically, we introduced a multi-scale supervised dense nested attention network designed to segment the PVSs. This model fosters progressive interactions between high-level and low-level features. Simultaneously, it utilizes multi-scale foreground content for deep supervision, aiding in refining segmentation results at various levels. Result: Our method achieved the best segmentation results compared with the four other deep-learning-based methods, achieving a dice similarity coefficient (DSC) of 0.702. The results of the visual count of the PVSs in our model correlated extremely well with the expert scoring results on the T2-weighted images (basal ganglia: rs = 0.845, P < 0.001; rs = 0.868, P < 0.001; centrum semiovale: rs = 0.845, P < 0.001; rs = 0.823, P < 0.001 for raters 1 and 2, respectively). Experimental results show that the proposed method performs well in the segmentation of PVSs. Conclusion: The proposed method can accurately segment PVSs; it will facilitate practical clinical applications and is expected to replace the method of visual counting directly on T1-weighted images or T2-weighted images.

15.
Childs Nerv Syst ; 2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-39269463

RESUMEN

BACKGROUND: The perivascular spaces of the brain are also known as Virchow-Robin spaces (VRSs). Dilated Virchow-Robin spaces in the brainstem are rare and mainly cause symptoms due to obstructive hydrocephalus, less frequently because of their size, mass effect, and impact on eloquent structures. CASE ILLUSTRATION: We present a patient with giant tumefactive VRS with hydrocephalus and neurological symptoms who was treated with endoscopic third ventriculostomy (ETV) followed by microscopic cyst fenestration. On the basis of this observation, we performed a thorough review of the literature to evaluate different treatment options. RESULTS: An 11-year-old girl presented with a headache for 3 months. The patient had a giant tumefactive mesencephalothalamic VRS with triventricular hydrocephalus. She was initially treated with endoscopic third ventriculostomy and multiple cyst fenestration. Symptomatic cyst regrowth required multiple cyst fenestrations via transcallosal transchoroidal (N = 2) and subtemporal approaches (N = 1) at the 2- and 4-year follow-ups. A literature review of these conditions allowed the detection of 12 cases (including our index case), and only 25% (3/12) of the patients underwent cyst fenestration 16.7% (2/12) required endoscopic fenestration and 8.3% (1/12) required microscopic fenestration. CONCLUSION: Giant mesencephalothalamic dVRSs are rare in the pediatric population. These patients are usually symptomatic due to obstructive hydrocephalus. Surgical options are endoscopic third ventriculostomy, ventricular shunt procedures, or direct cyst fenestration (microscopic or endoscopic). Close follow-up is mandatory owing to the risk of progression of the disease. Cyst fenestration resolves symptoms immediately, as it addresses both hydrocephalus and mass effects due to the cystic lesion in the same setting.

16.
Neuroimage ; 298: 120803, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39181194

RESUMEN

BACKGROUND: Perivascular spaces (PVS) visible on magnetic resonance imaging (MRI) are significant markers associated with various neurological diseases. Although quantitative analysis of PVS may enhance sensitivity and improve consistency across studies, the field lacks a universally validated method for analyzing images from multi-center studies. METHODS: We annotated PVS on multi-center 3D T1-weighted (T1w) images acquired using scanners from three major vendors (Siemens, General Electric, and Philips). A neural network, mcPVS-Net (multi-center PVS segmentation network), was trained using data from 40 subjects and then tested in a separate cohort of 15 subjects. We assessed segmentation accuracy against ground truth masks tailored for each scanner vendor. Additionally, we evaluated the agreement between segmented PVS volumes and visual scores for each scanner. We also explored correlations between PVS volumes and various clinical factors such as age, hypertension, and white matter hyperintensities (WMH) in a larger sample of 1020 subjects. Furthermore, mcPVS-Net was applied to a new dataset comprising both T1w and T2-weighted (T2w) images from a United Imaging scanner to investigate if PVS volumes could discriminate between subjects with differing visual scores. We also compared the mcPVS-Net with a previously published method that segments PVS from T1 images. RESULTS: In the test dataset, mcPVS-Net achieved a mean DICE coefficient of 0.80, with an average Precision of 0.81 and Recall of 0.79, indicating good specificity and sensitivity. The segmented PVS volumes were significantly associated with visual scores in both the basal ganglia (r = 0.541, p < 0.001) and white matter regions (r = 0.706, p < 0.001), and PVS volumes were significantly different among subjects with varying visual scores. Segmentation performance was consistent across different scanner vendors. PVS volumes exhibited significant associations with age, hypertension, and WMH. In the United Imaging scanner dataset, PVS volumes showed good associations with PVS visual scores evaluated on either T1w or T2w images. Compared to a previously published method, mcPVS-Net showed a higher accuracy and improved PVS segmentation in the basal ganglia region. CONCLUSION: The mcPVS-Net demonstrated good accuracy for segmenting PVS from 3D T1w images. It may serve as a useful tool for future PVS research.


Asunto(s)
Imagen por Resonancia Magnética , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Femenino , Anciano , Persona de Mediana Edad , Sistema Glinfático/diagnóstico por imagen , Redes Neurales de la Computación , Adulto , Procesamiento de Imagen Asistido por Computador/métodos , Sustancia Blanca/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Neuroimagen/métodos , Neuroimagen/normas , Conjuntos de Datos como Asunto , Anciano de 80 o más Años , Reproducibilidad de los Resultados
17.
Health Place ; 89: 103335, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39154413

RESUMEN

BACKGROUND: Urban environments pose challenges to mental health, an issue that Urban Green Spaces (UGS) can potentially mitigate. While the benefits of nature contact for mental wellbeing are recognized, a multidimensional analysis remains unexplored. PURPOSE: This study aims to fill this gap by examining the association between nature contact within UGS and mental health. It underscores the importance of considering multiple dimensions of nature engagement-such as naturalness, intensity, duration, frequency, and infrastructure-in enhancing psychological wellbeing. METHOD: A comprehensive analysis, including canonical correlation, multivariate analyses of variance, and Fisher discriminant analysis, was applied to survey data from several Brazilian metropolitan cities to assess how different aspects of nature contact influence mental health. RESULTS AND CONCLUSIONS: Findings reveal association between these dimensions and mental wellbeing indicators, highlighting the importance of a multidimensional perspective. PRACTICAL IMPLICATIONS: Results advocate for incorporating diverse aspects of nature contact in UGS design and policy-making to enhance urban dwellers' mental health. FUTURE DIRECTIONS: Further research should focus on longitudinal studies and explore the mediating effects of socio-demographic factors. Additionally, expanding research to include other developing countries will provide valuable comparative insights.


Asunto(s)
Ciudades , Salud Mental , Parques Recreativos , Humanos , Brasil , Masculino , Femenino , Adulto , Encuestas y Cuestionarios , Persona de Mediana Edad , Población Urbana , Planificación Ambiental , Adolescente
18.
Front Psychol ; 15: 1379330, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39193028

RESUMEN

Interpersonal curiosity (IPC), or the desire for information about others, is a core component of human connection, belonging, security, survival, and flourishing. Current research on leveraging IPC is scarce, making it an overlooked mechanism for building safer relational spaces. This narrative literature review attempts to answer the following questions: how can IPC facilitate safe relational spaces? How can this knowledge be made accessible and actionable for readers working in relational fields or public health? Results from the analysis of 23 articles indicate that IPC can manifest as either a trait or a state. At best, IPC can be a powerful tool for connection. At worst, IPC can lead to non-prosocial behaviors and relational disruptions. Suggestions are provided to harness the potential of IPC to foster quality connection and safer relational spaces.

19.
Cureus ; 16(8): e67912, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39193062

RESUMEN

Introduction Cervical suppurations represent an emergency pathology, with a dramatic evolution in the absence of adequate treatment. It frequently affects young people, hence the medico-legal implications of these cases. The anatomical substrate for the development of these deep cervical suppurations is represented by the cervical fascia and spaces. A distinct and extremely serious sub-chapter within diffuse cervical suppurations is necrotic cervical fasciitis, a polymicrobial infection with the most common oropharyngeal or odontogenic starting point, with rapidly progressive, destructive evolution in the deep fascial planes of the neck. Materials and method We will present a retrospective clinical study carried out on 26 cases diagnosed and treated between September 2013 and September 2018 in the ENT Clinic Department of the Bucharest University Emergency Hospital. Results Our retrospective analysis of a cohort of 26 patients in a tertiary referral center showed that deep cervical suppurations are slightly more common in men than in women. The most affected age groups were 50-59 years, followed by 20-29 years, representing a percentage of 53.84% of all cases. Also, 53.84% of the studied patients with deep cervical suppurations had a precarious and modest status. The most common clinical signs at presentation were malaise, cervical swelling, neck pain, dysphagia, fever, dysphonia, dyspnea, and cervical erythema. More than 60% of suppurations were odontogenic and 23% were caused by a traumatic element. Diabetes mellitus represents a comorbidity in 30.8% of patients, while 42.3% of patients had no personal pathological history, and thus this pathology has a lethal potential also in a patient in full health. In the study group, 46 (15%) had cervicomediastinitis, and 61.53% developed necrotizing fasciitis. One-third (34.61%) of our patients had undergone previous drainage surgery. Bacteriological examinations of the wound were with group C, D, G betahemolytic streptococcus, while 61.53% of the cultures were negative. Most patients required at least two cervicotomies. The average duration of hospitalization was 28.26 days, and the mortality rate was 23.07%; therefore, practically, one out of four cases resulted in death. In the studied group, no direct relationship can be established between the length of hospitalization and the favorable and unfavorable evolution of the patient. We propose a 10-step management protocol for the management of a cervical suppuration. Conclusion The multidisciplinary approach to these suppurations by the head and neck surgeon, the thoracic surgeon, the oromaxillofacial surgeon, anesthetist, imagist, specialist in infectious diseases, pathologist, psychologist, and so on, is the key to success in a patient who presents not only a suppuration in the throat but also a disease with systemic resonance and significant lethal potential.

20.
J Alzheimers Dis ; 101(2): 627-636, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39213072

RESUMEN

Background: Recent studies have demonstrated an association between pulse wave velocity (PWV), cerebral small vessel disease (SVD), and cognitive impairment such as Alzheimer's disease. However, the association between brachial-ankle PWV and enlarged perivascular spaces (EPVS), one component of cerebral SVD remains controversial. Objective: To investigate the relationship between brachial-ankle PWV and EPVS severity in participants without dementia. Methods: We performed a cross-sectional study of data of 74 participants from sub-analysis of ongoing research. We assessed cognitive function, brachial-ankle PWV, and brain magnetic resonance imaging (MRI) features. Using brain MRI, EPVS were separately assessed as basal ganglia (BG)-EPVS or centrum semiovale (CSO)-EPVS on the basis of their location. The relationship between EPVS severity and brachial-ankle PWV was evaluated using multivariable ordinal logistic regression analyses. Results: We analyzed 74 participants (women: 47%, mean age: 73 years, mild cognitive impairment [MCI]: 74%). Compared with participants with normal cognition, those with MCI were more likely to have both severe BG-EPVS and severe CSO-EPVS. In multivariable analyses, high brachial-ankle PWV and age were independently associated with BG-EPVS severity (odds ratio [95% confidence interval]: 1.19 [1.02-1.38], 1.09 [1.01-1.17], respectively), whereas only age was independently associated with CSO-EPVS severity. A causal mediation analysis under a counterfactual approach revealed a significant pure natural indirect effect of brachial-ankle PWV on MCI that was mediated by BG-EPVS (estimate: 1.04, 95% CI: 1.01-1.12, p = 0.006). Conclusions: Brachial-ankle PWV was associated with BG-EPVS severity. High PWV may cause cerebrovascular pulsatility, which accelerates BG-EPVS and may worsen cognitive impairment.


Asunto(s)
Disfunción Cognitiva , Sistema Glinfático , Imagen por Resonancia Magnética , Análisis de la Onda del Pulso , Humanos , Femenino , Masculino , Estudios Transversales , Anciano , Disfunción Cognitiva/fisiopatología , Disfunción Cognitiva/diagnóstico por imagen , Sistema Glinfático/diagnóstico por imagen , Enfermedades de los Pequeños Vasos Cerebrales/diagnóstico por imagen , Enfermedades de los Pequeños Vasos Cerebrales/fisiopatología , Enfermedades de los Pequeños Vasos Cerebrales/patología , Índice Tobillo Braquial , Anciano de 80 o más Años , Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Persona de Mediana Edad
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