Selective Neuronal Vulnerability in Alzheimer's Disease: A Network-Based Analysis.

A major obstacle to treating Alzheimer's disease (AD) is our lack of understanding of the molecular mechanisms underlying selective neuronal vulnerability, a key characteristic of the disease. Here, we present a framework integrating high-quality neuron-type-specific molecular profiles across the lifetime of the healthy mouse, which we generated using bacTRAP, with postmortem human functional genomics and quantitative genetics data. We demonstrate human-mouse conservation of cellular taxonomy at the molecular level for neurons vulnerable and resistant in AD, identify specific genes and pathways associated with AD neuropathology, and pinpoint a specific functional gene module underlying selective vulnerability, enriched in processes associated with axonal remodeling, and affected by amyloid accumulation and aging. We have made all cell-type-specific profiles and functional networks available at http://alz.princeton.edu. Overall, our study provides a molecular framework for understanding the complex interplay between Aß, aging, and neurodegeneration within the most vulnerable neurons in AD.

Diets for South Asians with diabetes: recommendations, adherence, and outcomes.

BACKGROUND AND OBJECTIVES: To determine how frequently diabetic diets are recommended to individuals with diabetes in South Asia, whether they are followed, and if they are associated with healthier dietary choices and clinical benefits. METHODS AND STUDY DESIGN: Data are from the Centre for cArdiometabolic Risk Reduction in South-Asia Cohort Study. Participants with self-reported physician-diagnosed diabetes (n=1849) were divided into four groups based on whether they reported being prescribed and/or were following a diabetic diet. Linear regression was used to estimate associations between these groups and outcomes. RESULTS: 53% of participants with self-reported diabetes reported not being prescribed or following a diabetic diet. Among those prescribed and following a diet, mean whole grain consumption was 1.18 times/day and refined grain consumption was 0.75 times/day compared to 0.88 times/day and 1.74 times/day, respectively, among those neither prescribed nor following a diet (both p<0.0001). Following a diet despite not being prescribed a diet was not associated with glycemic control, blood pressure, or body mass index, but was associated with a -8.54 mg/dL (95% confidence interval: -15.5, -1.58) lower low-density lipoprotein cholesterol compared to not following and not being prescribed a diet after adjustment for confounders. CONCLUSION: Though participants who were prescribed diabetic diets and followed them exhibited healthier dietary choices, the majority of participants with diabetes in urban South Asia was neither prescribed nor followed such diets. Moreover, there was no statistically significant clinical benefit, thus indicating that current dietary modifications may not be large enough or consistent enough to produce meaningful changes in health outcomes in this population.

Severe Kaposi Sarcoma in an Urban Public Hospital.

The national incidence of epidemic Kaposi sarcoma (KS) has decreased dramatically since the availability of combined antiretroviral therapy. Despite national trends, we continue to see admissions for KS. Electronic medical records were queried to identify patients with HIV who were admitted with active KS between 2010 and 2013 and records were reviewed to determine patient characteristics and factors affecting survival. Data were collected from all hospital admissions until death or May 1, 2015. Kaplan-Meier survival analysis with log-rank tests were used to test for differences in survival and Cox proportional hazards models were used to assess the prognostic value of variables. Odds ratios were calculated to determine factors associated with death during hospital admissions. Forty-three patients were admitted 141 times, with 81 admissions specifically related to KS. The majority of patients were highly immunosuppressed when KS was diagnosed (median CD4 count: 11), and 68% had multiple organ involvement with KS. Comorbidities at diagnosis included hepatitis B (26%) and pneumocystis pneumonia (33%). Frequent reasons for admission included skin and soft tissue complaints (28.4%) and respiratory complaints (27.2%). The estimated median survival after KS diagnosis was 3.0 years. Lung involvement, liver involvement, poor performance status, and low CD4 T cell count (<50) were associated with lower survival. Lung infections were the only admission diagnoses significantly associated with an increased odds of death during admission (OR: 5.42, 95% CI: 1.04-28.24). KS in our population is associated with poor access to healthcare and management of HIV. Factors affecting survival, including CD4 count and pulmonary involvement of KS, are in accordance with previous studies. Pulmonary KS should therefore be considered early in AIDS patients presenting with respiratory complaints. Our study also demonstrated that respiratory infections are associated with significant morbidity in patients with KS.