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1.
ACS Macro Lett ; : 1245-1250, 2024 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-39259499

RESUMO

Long-chain aliphatic polyesters are emerging sustainable materials that exhibit polyethylene-like properties while being amenable to chemical recycling and biodegradation. However, varying polyester chemical structures results in markedly different degradation rates, which cannot be predicted from commonly correlated bulk polyester properties, such as polymer melting temperature. To elucidate these structure-degradability relationships, long-chain polyesters varying in their monomer composition and crystallinity were subjected to enzymatic hydrolysis, the rates of which were quantified via detection of formed monomers. Copolymers with poorly water-soluble, long-chain diol monomers (e.g., 1,18-octadecanediol) demonstrated strongly reduced depolymerization rates compared to copolymers with shorter chain length diol monomers. This was illustrated by, e.g., the 20× faster hydrolysis of PE-4,18, consisting of 1,4-butanediol and 1,18-octadecanedicarboxylic acid monomers, relative to PE-18,4. The insoluble long-chain diol monomer released upon hydrolysis was proposed to remain attached to the bulk polymer surface, decreasing the accessibility of the remaining ester bonds to enzymes for further hydrolysis. Tuning of polyester crystallinity via the introduction of branched monomers led to variable hydrolysis rates, which increased by an order of magnitude when crystallinity decreased from 72% to 45%. The results reported enables the informed design of polyester structures with balanced material properties and amenability to depolymerization.

2.
JAMA Netw Open ; 7(9): e2432415, 2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39254975

RESUMO

Importance: Median organ waiting times published by transplant organizations may be biased when not appropriately accounting for censoring, death, and competing events. This can lead to overly optimistic waiting times for all transplant programs and, consequently, may deceive patients on the waiting list, transplant physicians, and health care policymakers. Objective: To apply competing-risk multistate models to calculate probabilities for transplantation and adverse outcomes on the Swiss national transplant waiting list. Design, Setting, and Participants: The WAIT (Waitlist Analysis in Transplantation) study was a retrospective cohort study of all transplant candidates in Switzerland listed from January 1, 2018, or later and observed until December 31, 2023. Transplant candidates were listed in 1 of the 6 transplant centers (Basel, Bern, Geneva, Lausanne, St Gallen, and Zurich) for heart, liver, lungs, kidney, or pancreas and/or islet transplant. A total of 4352 candidates were listed during the study period, of whom 709 (16.3%) were excluded due to living-donor transplant (691 in the kidney program and 18 in the liver program). Exposure: Waiting for organ transplant. Main Outcomes and Measures: Time to transplantation, death, or delisting. Competing-risk multistate models were used to analyze time-to-event data from the national organ waiting list with the Aalen-Johansen estimator to compute probabilities for both transplant and adverse outcomes. Results were compared with the sample median among only those undergoing transplant and the Kaplan-Meier method with censoring of competing events. Results: Data from 3643 transplant candidates (2428 [66.6%] male; median age, 56 [range, 0-79] years) were included in the analysis. The median time to transplantation (MTT) was 0.91 (95% CI, 0.83-1.07) years for heart, 3.10 (95% CI, 2.57-3.77) years for kidney, 1.32 (95% CI, 0.76-1.55) years for liver, 0.80 (95% CI, 0.37-1.12) years for lung, and 1.62 (95% CI, 0.91-2.17) years for pancreas and/or islet programs. Alternative estimation methods introduced bias to varying degrees: the sample median among only persons undergoing transplantation underestimated the waiting time by 38% to 61% and the Kaplan-Meier method by 2% to 12% compared with the MTT. Conclusions and Relevance: In this cohort study of transplant candidates in Switzerland, the MTT, the duration at which the transplant probability is 0.50, was used as a measure of average waiting time. Suboptimal methods led to biased and overly optimistic waiting time estimations; thus, applying appropriate competing-risk methods to address censoring and competing events is crucial.


Assuntos
Transplante de Órgãos , Listas de Espera , Humanos , Estudos Retrospectivos , Masculino , Transplante de Órgãos/estatística & dados numéricos , Feminino , Suíça , Pessoa de Meia-Idade , Adulto , Viés de Seleção , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Fatores de Tempo , Idoso
3.
Sensors (Basel) ; 24(14)2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-39065877

RESUMO

With the advancing energy transition, icing is a growing problem in the wind turbine sector. The development of systems to detect and mitigate icing makes it necessary to understand its basic behavior and characteristics. This paper proposes a method for the continuous and full-field measurement of the icing process of rotating blades, using a single line laser profile scanner. Inside of a climate chamber, a rotor is driven by a motor, while a system of nozzles provides a fine water dust, which leads to ice accumulating on simple NACA blades, which in turn is measured by a triangulation laser. The measurement data are cleared from outliers and presented as a surface in 3D space. An alpha shape is used to reconstruct and extract the volume of the ice between a reference and a measurement surface, using the corresponding Matlab function. Appropriate input parameters for the function and offsetting of the reference surface to improve the results are compared and discussed. The resulting system is able to detect small changes in the ice layer thickness in the sub-millimeter range.

4.
ACS Sustain Chem Eng ; 12(16): 6281-6288, 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38665800

RESUMO

The cross-linked nature of vulcanized rubbers as used in tire and many other applications prohibits an effective closed-loop mechanical or chemical recycling. Moreover, vulcanization significantly retards the material's biodegradation. Here, we report a recyclable and biodegradable rubber that is generated by the vulcanization of amorphous, unsaturated polyesters. The elastic material can be broken down via solvolysis into the underlying monomers. After removal of the vulcanized repeat units, the saturated monomers, constituting the major share of the material, can be recovered in overall recycling rates exceeding 90%. Respirometric biodegradation experiments by 13CO2 tracking under environmental conditions via the polyesters' diol monomer indicated depolymerization and partial mineralization of the vulcanized polyester rubbers.

5.
NEJM Evid ; 3(1): EVIDoa2300003, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38320512

RESUMO

BACKGROUND: We have examined the primary efficacy results of 23,551 randomized clinical trials from the Cochrane Database of Systematic Reviews. METHODS: We estimate that the great majority of trials have much lower statistical power for actual effects than the 80 or 90% for the stated effect sizes. Consequently, "statistically significant" estimates tend to seriously overestimate actual treatment effects, "nonsignificant" results often correspond to important effects, and efforts to replicate often fail to achieve "significance" and may even appear to contradict initial results. To address these issues, we reinterpret the P value in terms of a reference population of studies that are, or could have been, in the Cochrane Database. RESULTS: This leads to an empirical guide for the interpretation of an observed P value from a "typical" clinical trial in terms of the degree of overestimation of the reported effect, the probability of the effect's sign being wrong, and the predictive power of the trial. CONCLUSIONS: Such an interpretation provides additional insight about the effect under study and can guard medical researchers against naive interpretations of the P value and overoptimistic effect sizes. Because many research fields suffer from low power, our results are also relevant outside the medical domain. (Funded by the U.S. Office of Naval Research.)


Assuntos
Ensaios Clínicos Controlados Aleatórios como Assunto
6.
Chem Rev ; 124(5): 2327-2351, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38408312

RESUMO

Polyethylene deconstruction to reusable smaller molecules is hindered by the chemical inertness of its hydrocarbon chains. Pyrolysis and related approaches commonly require high temperatures, are energy-intensive, and yield mixtures of multiple classes of compounds. Selective cleavage reactions under mild conditions (

7.
Diagn Progn Res ; 7(1): 6, 2023 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-36879332

RESUMO

BACKGROUND: Many potential prognostic factors for predicting kidney transplantation outcomes have been identified. However, in Switzerland, no widely accepted prognostic model or risk score for transplantation outcomes is being routinely used in clinical practice yet. We aim to develop three prediction models for the prognosis of graft survival, quality of life, and graft function following transplantation in Switzerland. METHODS: The clinical kidney prediction models (KIDMO) are developed with data from a national multi-center cohort study (Swiss Transplant Cohort Study; STCS) and the Swiss Organ Allocation System (SOAS). The primary outcome is the kidney graft survival (with death of recipient as competing risk); the secondary outcomes are the quality of life (patient-reported health status) at 12 months and estimated glomerular filtration rate (eGFR) slope. Organ donor, transplantation, and recipient-related clinical information will be used as predictors at the time of organ allocation. We will use a Fine & Gray subdistribution model and linear mixed-effects models for the primary and the two secondary outcomes, respectively. Model optimism, calibration, discrimination, and heterogeneity between transplant centres will be assessed using bootstrapping, internal-external cross-validation, and methods from meta-analysis. DISCUSSION: Thorough evaluation of the existing risk scores for the kidney graft survival or patient-reported outcomes has been lacking in the Swiss transplant setting. In order to be useful in clinical practice, a prognostic score needs to be valid, reliable, clinically relevant, and preferably integrated into the decision-making process to improve long-term patient outcomes and support informed decisions for clinicians and their patients. The state-of-the-art methodology by taking into account competing risks and variable selection using expert knowledge is applied to data from a nationwide prospective multi-center cohort study. Ideally, healthcare providers together with patients can predetermine the risk they are willing to accept from a deceased-donor kidney, with graft survival, quality of life, and graft function estimates available for their consideration. STUDY REGISTRATION: Open Science Framework ID: z6mvj.

8.
Angew Chem Int Ed Engl ; 62(6): e202213438, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-36480133

RESUMO

We report a novel polyester material generated from readily available biobased 1,18-octadecanedicarboxylic acid and ethylene glycol possesses a polyethylene-like solid-state structure and also tensile properties similar to high density polyethylene (HDPE). Despite its crystallinity, high melting point (Tm =96 °C) and hydrophobic nature, polyester-2,18 is subject to rapid and complete hydrolytic degradation in in vitro assays with isolated naturally occurring enzymes. Under industrial composting conditions (ISO standard 14855-1) the material is biodegraded with mineralization above 95 % within two months. Reference studies with polyester-18,18 (Tm =99 °C) reveal a strong impact of the nature of the diol repeating unit on degradation rates, possibly related to the density of ester groups in the amorphous phase. Depolymerization by methanolysis indicates suitability for closed-loop recycling.


Assuntos
Poliésteres , Polietileno , Biodegradação Ambiental , Poliésteres/química , Hidrólise
9.
F1000Res ; 12: 588, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38983445

RESUMO

Background: The quality of COVID-19 preprints should be considered with great care, as their contents can influence public policy. Surprisingly little has been done to calibrate the public's evaluation of preprints and their contents. The PRECHECK project aimed to generate a tool to teach and guide scientifically literate non-experts to critically evaluate preprints, on COVID-19 and beyond. Methods: To create a checklist, we applied a four-step procedure consisting of an initial internal review, an external review by a pool of experts (methodologists, meta-researchers/experts on preprints, journal editors, and science journalists), a final internal review, and a Preliminary implementation stage. For the external review step, experts rated the relevance of each element of the checklist on five-point Likert scales, and provided written feedback. After each internal review round, we applied the checklist on a small set of high-quality preprints from an online list of milestone research works on COVID-19 and low-quality preprints, which were eventually retracted, to verify whether the checklist can discriminate between the two categories. Results: At the external review step, 26 of the 54 contacted experts responded. The final checklist contained four elements (Research question, study type, transparency and integrity, and limitations), with 'superficial' and 'deep' evaluation levels. When using both levels, the checklist was effective at discriminating a small set of high- and low-quality preprints. Its usability for assessment and discussion of preprints was confirmed in workshops with Bachelors students in Psychology and Medicine, and science journalists. Conclusions: We created a simple, easy-to-use tool for helping scientifically literate non-experts navigate preprints with a critical mind and facilitate discussions within, for example, a beginner-level lecture on research methods. We believe that our checklist has potential to help guide decisions about the quality of preprints on COVID-19 in our target audience and that this extends beyond COVID-19.


Assuntos
COVID-19 , Lista de Checagem , Humanos , Inquéritos e Questionários , SARS-CoV-2 , Pré-Publicações como Assunto , Retroalimentação
10.
PLoS One ; 17(12): e0276221, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36454744

RESUMO

Mental disorders often emerge during adolescence and have been associated with age-related differences in connection strengths of brain networks (static functional connectivity), manifesting in non-typical trajectories of brain development. However, little is known about the direction of information flow (directed functional connectivity) in this period of functional brain progression. We employed dynamic graphical models (DGM) to estimate directed functional connectivity from resting state functional magnetic resonance imaging data on 1143 participants, aged 6 to 17 years from the healthy brain network (HBN) sample. We tested for effects of age, sex, cognitive abilities and psychopathology on estimates of direction flow. Across participants, we show a pattern of reciprocal information flow between visual-medial and visual-lateral connections, in line with findings in adults. Investigating directed connectivity patterns between networks, we observed a positive association for age and direction flow from the cerebellar to the auditory network, and for the auditory to the sensorimotor network. Further, higher cognitive abilities were linked to lower information flow from the visual occipital to the default mode network. Additionally, examining the degree networks overall send and receive information to each other, we identified age-related effects implicating the right frontoparietal and sensorimotor network. However, we did not find any associations with psychopathology. Our results suggest that the directed functional connectivity of large-scale resting-state brain networks is sensitive to age and cognition during adolescence, warranting further studies that may explore directed relationships at rest and trajectories in more fine-grained network parcellations and in different populations.


Assuntos
Transtornos Mentais , Psicopatologia , Adulto , Criança , Humanos , Adolescente , Encéfalo/diagnóstico por imagem , Cognição , Cerebelo
11.
Front Psychiatry ; 13: 909992, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35845462

RESUMO

Alcohol use disorder (AUD) is characterized by enhanced cue-reactivity and the opposing control processes being insufficient. The ability to inhibit reactions to alcohol-related cues, alcohol-specific inhibition, is thus crucial to AUD; and trainings strengthening this ability might increase treatment outcome. The present study investigated whether neurophysiological correlates of alcohol-specific inhibition (I) vary with craving, (II) predict drinking outcome in AUD and (III) are modulated by alcohol-specific inhibition training. A total of 45 recently abstinent patients with AUD and 25 controls participated in this study. All participants underwent functional magnetic resonance imaging (fMRI) during a Go-NoGo task with alcohol-related as well as neutral conditions. Patients with AUD additionally participated in a double-blind RCT, where they were randomized to either an alcohol-specific inhibition training or an active control condition (non-specific inhibition training). After the training, patients participated in a second fMRI measurement where the Go-NoGo task was repeated. Percentage of days abstinent was assessed as drinking outcome 3 months after discharge from residential treatment. Whole brain analyses indicated that in the right inferior frontal gyrus (rIFG), activation related to alcohol-specific inhibition varied with craving and predicted drinking outcome at 3-months follow-up. This neurophysiological correlate of alcohol-specific inhibition was however not modulated by the training version. Our results suggest that enhanced rIFG activation during alcohol-specific (compared to neutral) inhibition (I) is needed to inhibit responses when craving is high and (II) fosters sustained abstinence in patients with AUD. As alcohol-specific rIFG activation was not affected by the training, future research might investigate whether potential training effects on neurophysiology are better detectable with other methodological approaches.

13.
BMC Geriatr ; 22(1): 247, 2022 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-35331147

RESUMO

BACKGROUND: With age, medical conditions impairing safe driving accumulate. Consequently, the risk of accidents increases. To mitigate this risk, Swiss law requires biannual assessments of the fitness to drive of elderly drivers. Drivers may prove their cognitive and physical capacity for safe driving in a medically supervised driving test (MSDT) when borderline cases, as indicated by low performance in a set of four cognitive tests, including e.g. the mini mental status test (MMST). Any prognostic, rather than indicative, relations for MSDT outcomes have neither been confirmed nor falsified so far. In order to avoid use of unsubstantiated rules of thumb, we here evaluate the predictive value for MSDT outcomes of the outcomes of the standard set of four cognitive tests, used in Swiss traffic medicine examinations. METHODS: We present descriptive information on age, gender and cognitive pretesting results of all MSDTs recorded in our case database from 2017 to 2019. Based on these retrospective cohort data, we used logistic regression to predict the binary outcome MSDT. An exploratory analysis used all available data (model 1). Based on the Akaike Information Criterion (AIC), we then established a model including variables age and MMST (model 2). To evaluate the predictive value of the four cognitive assessments, model 3 included cognitive test outcomes only. Receiver operating characteristics (ROC) and area under the curve (AUC) allowed evaluating discriminative performance of the three different models using independent validation data. RESULTS: Using N = 188 complete data sets of a total of 225 included cases, AIC identified age (p < 0.0008) and MMST (p = 0.024) as dominating predictors for MSDT outcomes with a median AUC of 0.71 (95%-CI 0.57-0.85) across different training and validation splits, while using the four cognitive test results exclusively yielded a median AUC of 0.55 (95%-CI 0.40-0.71). CONCLUSIONS: Our analysis provided strong evidence for age as the single most dominant predictor of MSDT outcomes. Adding MMST provides only weak additional predictive value for MSDT outcomes. Combining the results of four cognitive test used as standard screen in Swiss traffic medicine alone, proved to be of poor predictive value. This highlights the importance of MSDTs for balancing between the mitigation of risks by and the right to drive for the elderly.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Acidentes de Trânsito/prevenção & controle , Idoso , Condução de Veículo/psicologia , Humanos , Testes de Estado Mental e Demência , Testes Neuropsicológicos , Estudos Retrospectivos
14.
BMJ Open ; 11(9): e045942, 2021 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521659

RESUMO

OBJECTIVES: To assess the prevalence of statistically significant treatment effects, adverse events and small-study effects (when small studies report more extreme results than large studies) and publication bias (over-reporting of statistically significant results) across medical specialties. DESIGN: Large meta-epidemiological study of treatment effects from the Cochrane Database of Systematic Reviews. METHODS: We investigated outcomes from 57 162 studies from 1922 to 2019, and overall 98 966 meta-analyses and 5534 large meta-analyses (≥10 studies). Egger's and Harbord's tests to detect small-study effects, limit meta-analysis and Copas selection models to bias-adjust effect estimates and generalised linear mixed models were used to analyse one of the largest collections of evidence in medicine. RESULTS: Medical specialties showed differences in the prevalence of statistically significant results of efficacy and safety outcomes. Treatment effects from primary studies published in high ranking journals were more likely to be statistically significant (OR=1.52; 95% CI 1.32 to 1.75) while randomised controlled trials were less likely to report a statistically significant effect (OR=0.90; 95% CI 0.86 to 0.94). Altogether 19% (95% CI 18% to 20%) of the large meta-analyses showed evidence for small-study effects, but only 3.9% (95% CI 3.4% to 4.4%) showed evidence for publication bias after further assessment of funnel plots. Adjusting treatment effects resulted in overall less evidence for efficacy. CONCLUSIONS: These results suggest that reporting of large treatment effects from small studies may cause greater concern than publication bias. Incentives should be created so that studies of the highest quality become more visible than studies that report more extreme results.


Assuntos
Gerenciamento de Dados , Medicina , Estudos Epidemiológicos , Humanos , Metanálise como Assunto , Viés de Publicação , Revisões Sistemáticas como Assunto
15.
Stat Med ; 40(27): 6107-6117, 2021 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-34425632

RESUMO

We abstract the concept of a randomized controlled trial as a triple (ß,b,s) , where ß is the primary efficacy parameter, b the estimate, and s the standard error ( s>0 ). If the parameter ß is either a difference of means, a log odds ratio or a log hazard ratio, then it is reasonable to assume that b is unbiased and normally distributed. This then allows us to estimate the joint distribution of the z-value z=b/s and the signal-to-noise ratio SNR=ß/s from a sample of pairs (bi,si) . We have collected 23 551 such pairs from the Cochrane database. We note that there are many statistical quantities that depend on (ß,b,s) only through the pair (z,SNR) . We start by determining the estimated distribution of the achieved power. In particular, we estimate the median achieved power to be only 13%. We also consider the exaggeration ratio which is the factor by which the magnitude of ß is overestimated. We find that if the estimate is just significant at the 5% level, we would expect it to overestimate the true effect by a factor of 1.7. This exaggeration is sometimes referred to as the winner's curse and it is undoubtedly to a considerable extent responsible for disappointing replication results. For this reason, we believe it is important to shrink the unbiased estimator, and we propose a method for doing so. We show that our shrinkage estimator successfully addresses the exaggeration. As an example, we re-analyze the ANDROMEDA-SHOCK trial.


Assuntos
Projetos de Pesquisa , Humanos , Razão de Chances , Modelos de Riscos Proporcionais
16.
Materials (Basel) ; 14(16)2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34443160

RESUMO

Tooling, especially for prototyping or small series, may prove to be very costly. Further, prototyping of fiber reinforced thermoplastic shell structures may rely on time-consuming manual efforts. This perspective paper discusses the idea of fabricating tools at reduced time and cost compared to conventional machining-based methods. The targeted tools are manufactured out of sand using the Binder Jetting process. These molds should fulfill the demands regarding flexural and compressive behavior while allowing for vacuum thermoforming of fiber reinforced thermoplastic sheets. The paper discusses the requirements and the challenges and presents a perspective study addressing this innovative idea. The authors present the idea for discussion in the additive manufacturing and FRP producing communities.

17.
Neuron ; 109(11): 1769-1775, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-33932337

RESUMO

Brainhack is an innovative meeting format that promotes scientific collaboration and education in an open, inclusive environment. This NeuroView describes the myriad benefits for participants and the research community and how Brainhacks complement conventional formats to augment scientific progress.


Assuntos
Comunicação , Internet , Neurociências/organização & administração , Congressos como Assunto , Guias de Prática Clínica como Assunto
18.
Hum Brain Mapp ; 41(15): 4173-4186, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-32613721

RESUMO

Functional interconnections between brain regions define the "connectome" which is of central interest for understanding human brain function. Resting-state functional magnetic resonance (rsfMRI) work has revealed changes in static connectivity related to age, sex, cognitive abilities and psychiatric symptoms, yet little is known how these factors may alter the information flow. The commonly used approach infers functional brain connectivity using stationary coefficients yielding static estimates of the undirected connection strength between brain regions. Dynamic graphical models (DGMs) are a multivariate model with dynamic coefficients reflecting directed temporal associations between nodes, and can yield novel insight into directed functional connectivity. Here, we leveraged this approach to test for associations between edge-wise estimates of direction flow across the functional connectome and age, sex, intellectual abilities and mental health. We applied DGM to investigate patterns of information flow in data from 984 individuals from the Human Connectome Project (HCP) and 10,249 individuals from the UK Biobank. Our analysis yielded patterns of directed connectivity in independent HCP and UK Biobank data similar to those previously reported, including that the cerebellum consistently receives information from other networks. We show robust associations between information flow and age and sex for several connections, with strongest effects of age observed in the sensorimotor network. Visual, auditory and sensorimotor nodes were also linked to mental health. Our findings support the use of DGM as a measure of directed connectivity in rsfMRI data and provide new insight into the shaping of the connectome during aging.


Assuntos
Envelhecimento/fisiologia , Sintomas Comportamentais/fisiopatologia , Encéfalo/fisiologia , Conectoma/métodos , Imageamento por Ressonância Magnética/métodos , Rede Nervosa/fisiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Sintomas Comportamentais/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Bases de Dados Factuais , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade , Rede Nervosa/diagnóstico por imagem , Fatores Sexuais , Adulto Jovem
19.
J Alzheimers Dis ; 76(4): 1461-1475, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32651312

RESUMO

BACKGROUND: Semantic memory impairments in semantic dementia are attributed to atrophy and functional disruption of the anterior temporal lobes. In contrast, the posterior medial temporal neurodegeneration found in Alzheimer's disease is associated with episodic memory disturbance. The two dementia subtypes share hippocampal deterioration, despite a relatively spared episodic memory in semantic dementia. OBJECTIVE: To unravel mutual and divergent functional alterations in Alzheimer's disease and semantic dementia, we assessed functional connectivity between temporal lobe regions in Alzheimer's disease (n = 16), semantic dementia (n = 23), and healthy controls (n = 17). METHODS: In an exploratory study, we used a functional parcellation of the temporal cortex to extract time series from 66 regions for correlation analysis. RESULTS: Apart from differing connections between Alzheimer's disease and semantic dementia that yielded reduced functional connectivity, we identified a common pathway between the right anterior temporal lobe and the right orbitofrontal cortex in both dementia subtypes. This disconnectivity might be related to social knowledge deficits as part of semantic memory decline. However, such interpretations are preferably made in a holistic context of disease-specific semantic impairments and functional connectivity changes. CONCLUSION: Despite a major limitation owed to unbalanced databases between study groups, this study provides a preliminary picture of the brain's functional disconnectivity in Alzheimer's disease and semantic dementia. Future studies are needed to replicate findings of a common pathway with consistent diagnostic criteria and neuropsychological evaluation, balanced designs, and matched data MRI acquisition procedures.


Assuntos
Doença de Alzheimer/patologia , Atrofia/patologia , Demência Frontotemporal/psicologia , Hipocampo/patologia , Lobo Temporal/patologia , Feminino , Hipocampo/fisiopatologia , Humanos , Masculino , Transtornos da Memória/patologia , Transtornos da Memória/psicologia , Memória Episódica , Pessoa de Meia-Idade , Testes Neuropsicológicos , Lobo Temporal/fisiopatologia
20.
Psychiatry Res Neuroimaging ; 300: 111066, 2020 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-32244111

RESUMO

Glucocorticoids reduce phobic fear in anxiety disorders and enhance psychotherapy, possibly by reducing the retrieval of fear memories and enhancing the consolidation of new corrective memories. Glucocorticoid signaling in the basolateral amygdala can influence connected fear and memory-related cortical regions, but this is not fully understood. Previous studies investigated specific pathways moderated by glucocorticoids, for example, visual-temporal pathways; however, these analyses were limited to a-priori selected regions. Here, we performed whole-brain pattern analysis to localize phobic stimulus decoding related to the fear-reducing effect of glucocorticoids. We reanalyzed functional magnetic resonance imaging (fMRI) data from a previously published study with spider-phobic patients and healthy controls. The patients received glucocorticoids or a placebo before the exposure to spider images. There was moderate evidence that patients with phobia had higher decoding of phobic content in the anterior cingulate cortex (ACC) and the left and right anterior insula compared to controls. Decoding in the ACC and the right insula showed strong evidence for correlation with experienced fear. Patients with cortisol reported a reduction of fear by 10-13%; however, there was only weak evidence for changes in neural decoding compared to placebo which was found in the precuneus, the opercular cortex, and the left cerebellum.


Assuntos
Córtex Cerebral/efeitos dos fármacos , Medo/efeitos dos fármacos , Glucocorticoides/farmacologia , Memória/efeitos dos fármacos , Transtornos Fóbicos/tratamento farmacológico , Adulto , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/fisiopatologia , Córtex Cerebral/fisiopatologia , Feminino , Giro do Cíngulo/efeitos dos fármacos , Giro do Cíngulo/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Transtornos Fóbicos/fisiopatologia , Aranhas
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