Validity and reliability of the Turkish version of the Australian National University-Alzheimer's Disease Risk Index (ANU-ADRI).

INTRODUCTION: There is still a requirement for concise, practical scales that can be readily incorporated into everyday schedules and predict the likelihood of dementia onset in individuals without dementia. This study aimed to assess the reliability of the ANU-ADRI (Australian National University Alzheimer's Disease Risk Index)-Short Form in Turkish geriatric patients. METHODS: This methodological study involved 339 elderly patients attending the geriatric outpatient clinic for various reasons. The known-group validity and divergent validity were assessed. The ANU-ADRI was administered during the baseline test and again within one week for retest purposes. Alongside the ANU-ADRI, all participants underwent a comprehensive geriatric assessment, including Activities of Daily Living (ADL), mobility assessment (Performance-Oriented Mobility Assessment (POMA) and Timed Up and Go Test), nutritional assessment (Mini Nutritional Assessment (MNA)), and global cognition evaluation (Mini-Mental State Examination (MMSE)). RESULTS: The scale demonstrated satisfactory linguistic validity. A correlation was observed between the mean scores of the ANU-ADRI test and retest (r = 0.997, p < 0.001). Additionally, there existed a moderate negative linear association between the ANU-ADRI and MMSE scores (r = -0.310, p < 0.001), POMA (r = -0.406, p < 0.001), Basic ADL (r = -0.359, p < 0.001), and Instrumental ADL (r = -0.294, p < 0.001). Moreover, a moderate positive linear association was found between the ANU-ADRI and the Timed Up and Go Test duration (r = 0.538, p < 0.001). CONCLUSION: The ANU-ADRI-Short Form was proved as a valuable tool for clinical practice, facilitating the assessment of Alzheimer's disease risk within the Turkish geriatric population.

Sarcopenia in older patients with idiopathic normal pressure hydrocephalus: an observational study from a single geriatric clinic in Turkey.

OBJECTIVE: Idiopathic normal pressure hydrocephalus (iNPH), a classical triad of gait abnormality, cognitive disturbance, and urinary incontinence, increases in prevalence with aging. Sarcopenia is also characterized by low muscle strength and mass, contributing to gait difficulty. Gait abnormality and lower physical activity also lead to the development of sarcopenia. Therefore, this study aims to investigate the relationship between sarcopenia and iNPH. METHODS: A total of 327 participants were included in this retrospective cross-sectional study. Demographic and clinical characteristics, including age, sex, comorbidity index, number of medications, recurrent falls in the last year, laboratory findings and comprehensive geriatric assessment (CGA) parameters were recorded. Sarcopenia was defined according to the EGWSOP2 criteria. The relationship between sarcopenia and iNPH was assessed with regression analysis. RESULTS: There were 51 participants with iNPH, 49% female, mean age 78 years (SD 5.7) and 276 control participants, 74% female, mean age 72 years (SD 6.1). The sarcopenia rates in patients with iNPH and controls were 19.6% and 2.5%, respectively (p < 0.01). The odds of probable sarcopenia were 3.89 times, and the slow gait speed was 8.47 times higher in iNPH patients than in controls after adjusting for age, sex, and the other confounders. The Mini-Mental State Examination score (p = 0.042, OR = 0.869 with 95% CI:0.759-0.995) was associated with probable sarcopenia among patients with iNPH. CONCLUSION: This study demonstrated that sarcopenia was common in older patients with iNPH, which seems to be closely associated with decreased muscle strength and slowed gait speed. Thus, considering the potential untoward effects of both diseases, it is important for physicians to evaluate sarcopenia routinely in the follow-up and treatment of older patients with iNPH.

Brain Banking in Dementia Studies.

It is now well-established practice in dementia that one clinical entity may be caused by various neurodegenerative disorders, each with different histopathological findings, whereas neuropathologically confirmed patients may have different, unusual, and atypical clinical manifestations.This inconsistency in dementia patients leads to neuropathological examination of cases, and neuropathological examination seems to be an inevitable part of dementia practice, at least until all clinical entities are properly identified for humans.Additionally, the development of disease-modifying therapies and confirmation of the actual accurate diagnosis of the neurodegenerative disease that the drug is thought to modify or act upon are of great importance for neuropathological evaluation in brain banks.Neuropathological processes coexisting among patients diagnosed with established clinical criteria or international guidelines have provided a new perspective in the context of drug development.Here, we review our routinely used methodology in the context of the brain banking process.

"Giant" Colloidal Quantum Well Heterostructures of CdSe@CdS Core@Shell Nanoplatelets from 9.5 to 17.5 Monolayers in Thickness Enabling Ultra-High Gain Lasing.

Semiconductor colloidal quantum wells (CQWs) have emerged as a promising class of gain materials to be used in colloidal lasers. Although low gain thresholds are achieved, the required high gain coefficient levels are barely met for the applications of electrically-driven lasers which entails a very thin gain matrix to avoid charge injection limitations. Here, "giant" CdSe@CdS colloidal quantum well heterostructures of 9.5 to 17.5 monolayers (ML) in total with corresponding vertical thickness from 3.0 to 5.8 nm that enable record optical gain is shown. These CQWs achieve ultra-high material gain coefficients up to ≈140 000 cm-1 , obtained by systematic variable stripe length (VSL) measurements and independently validated by transient absorption (TA) measurements, owing to their high number of states. This exceptional gain capacity is an order of magnitude higher than the best levels reported for the colloidal quantum dots. From the dispersion of these quantum wells, low threshold amplified spontaneous emission in water providing an excellent platform for optofluidic lasers is demonstrated. Also, employing these giant quantum wells, whispering gallery mode (WGM) lasing with an ultra-low threshold of 8 µJ cm-2 is demonstrated. These findings indicate that giant CQWs offer an exceptional platform for colloidal thin-film lasers and in-solution lasing applications.

Primitive reflexes and dementia in older adults: a meta-analysis of observational and cohort studies.

Primitive reflexes (PRs) are clinical signs that indicate diffuse cerebral dysfunction and frontal lesions. We aimed to present a comprehensive analysis of the prevalence and risk of PRs in patients with dementia. English-language articles published from January 1990 to April 2021 were searched in PubMed, ScienceDirect, Cochrane, and Web of Science with keywords. The titles and abstracts of the identified articles were screened to identify potentially relevant papers. Odds ratios and risk ratios were extracted with 95% confidence intervals and combined using the random-effects model after logarithmic transformation. The prevalence in dementia patients was also combined using the random-effects model. This meta-analysis involved 29 studies. The snout reflex (48% of cases) was the most prevalent. It was found that the risk of PRs in individuals with dementia was significantly elevated, ranging from 13.94 to 16.38 times higher than in healthy controls. The grasp reflex exhibited the highest risk for dementia. This meta-analysis showed that the prevalence and the risk of PRs is high in older patients with dementia. Therefore, PRs, especially the grasp reflex, should be carefully assessed as a part of routine physical examination in the diagnostic process for dementia.

Long non-coding RNA signatures in non-small cell lung cancer and their clinicopathological significance.

Lung cancer is the most common type of cancer in our country and worldwide, and it is a leading cause of cancer-related deaths. According to the latest global cancer statistics, lung cancer was identified as the second most common type of cancer, and the leading cause of cancer-related deaths. Long non-coding RNAs (lncRNAs) are a highly heterogeneous class of RNA molecules sharing many characteristics with mRNAs, except for the protein-coding potential. Accumulating mass of evidence suggest that lncRNAs play key regulatory roles during the multistep formation of human cancers including lung cancer. In previous studies, it has been shown that many lncRNA molecules play significant roles in the formation and progression of lung cancer. However, there are still numerous lncRNA molecules in lung cancer whose roles remain unknown. Accordingly, here we sought to ascertain the diagnostic and prognostic value of lncRNAs by analyzing the expression profiles of THRIL, NEAT1, and LOC105376095 in lung cancer. Remarkably, NEAT1 and LOC105376095 but not THRIL were identified to be differentially expressed in tissues of lung tumors. More importantly, LOC105376095, a yet uncharacterized lncRNA molecule, was significantly associated with the disease severity. Collectively, NEAT1 and LOC105376095 hold promise as potential diagnostic and prognostic biomarkers for lung cancer, presenting opportunities for targeted therapeutic interventions in the future.

Neuroleptic Malignant Syndrome in Patients With Dementia: Experiences of A Single Memory Clinic.

OBJECTIVES: Neuroleptic malignant syndrome (NMS) is a life-threatening condition that occurs as an adverse reaction to antipsychotic and antiemetic agents or sudden withdrawal of dopaminergic medications. Given the metabolic and functional reserves and the comorbidities in older adults, NMS may show an atypical course. METHODS: The medical records of patients with neurodegenerative diseases leading to dementia between 2013 and 2020 were reviewed for the diagnosis of NMS. Demographic and clinical characteristics of the patients were obtained from the records of laboratory parameters, management, and length of stay. RESULTS: Fifteen older adults (19 episodes) diagnosed with NMS were included. The median age was 76 years, and 5 were female. Ten of 15 NMS patients were atypical. Most of them had an infection accompanying NMS. Neuroleptic malignant syndrome was caused by antidopaminergic agents (5 antipsychotics, 1 metoclopramide) in 6 episodes and discontinuation of a dopaminergic agent, l -DOPA, in 12 episodes. In 1 patient, it was associated with simultaneous use of domperidone and amantadine withdrawal. Rigidity in NMS due to l -DOPA discontinuation was higher than in those due to antipsychotic use ( P = 0.027). Two of our patients needed intensive care, and 1 died. CONCLUSIONS: This study highlights the high frequency of atypical NMS and the importance of early recognition of this potentially fatal syndrome, which can accompany neurodegenerative diseases and infections in older adults.

An atypical presentation of COVID-19: Hidden risk for seniors to misdiagnose.

The outbreak of coronavirus disease (COVID-19) was announced as a pandemic by the World Health Organization in March 2020. Clinical manifestations include cough, fever, dyspnea, myalgia, and loss of sense of smell and taste. Less common extrapulmonary signs and symptoms such as cutaneous manifestations, diarrhea, confusion, functional decline have been reported in the literature. Older patients with multiple comorbidities are at a greater risk for severe disease and death and are vulnerable to atypical presentations due to changes in organ systems, multimorbidity, cognitive impairment, and sensory disturbances. In this case, a 77-year-old patient diagnosed with COVID-19 pneumonia presented with atypically acute urticaria with angioedema was reported. Although there were no typical signs of the disease, such as cough or shortness of breath, the patient's laboratory values, and chest imaging were compatible with COVID-19. Therefore, the diagnosis of COVID-19 should be considered in older patients presenting with subtle signs or cutaneous manifestations.

The Profiling of Apoptosis-Associated MicroRNA Expressions of the Lung Adenocarcinoma.

OBJECTIVE: The most common histopathological subtype of lung cancer is adenocarcinoma. MicroRNAs are a class of non-coding RNAs that play roles in the regulation of gene expression. MicroRNAs affecting apoptosis may have different roles in lung adenocarcinoma development, progression, and differentiation. The objective of this study is to profile all known microRNAs linked to apoptosis in normal and lung cancer tissue using real-time polymerase chain reaction. MATERIAL AND METHODS: Tissues with adenocarcinoma and healthy tissues were taken from the same lung. The degree of differentiation of all tumors was determined. Expressions of 84 apoptosis-associated microRNAs in both tissues were analyzed by real-time polymerase chain reaction array. RESULTS: Eleven patients and 22 samples were included in the study. In the comparison of expression levels of apoptosis-associated microRNAs in normal and adenocarcinoma tissue, miR-134, miR-183-5p, miR-192-5p, miR-193b-3, miR-194-5p, miR-200c-3, miR212-3p, miR-25-3p, miR-449a, and miR-9-5p showed significant difference in downregulation. Receiver operating characteristic curve analysis of 10 identified microRNAs was performed, and cut-off values, sensitivity, and specificity were determined. No significant difference was found between microRNA expression levels in adenocarcinoma tissues classified as moderate-well to poorly differentiated. CONCLUSION: Differently, downregulated expressed apoptosis-associated microRNAs were detected in lung adenocarcinoma tissues. MicroRNAs can be used as biomarkers in the diagnosis in lung adenocarcinoma. The expression of microRNAs linked to apoptosis should be investigated in different lung cancer histological subtypes in order to identify potential biomarkers.

Comparative assessment of primary cancer cell culture techniques and cellular composition analysis in non-small cell lung cancer.

Preclinical models are required to study individual therapy responses to improve all cancer treatments, particularly non-small cell lung cancer (NSCLC). Patient-derived explants (PDEs) culture model is of great importance in terms of the possibility of tumor cell culture with the microenvironment, and the development of molecular mechanisms and personalized treatment methods. In our study, primary tumor culture with microenvironment was performed using different methods from tumor tissues obtained from 51 patients with NSCLC. To identify the most efficient method, mechanical, enzymatic, and tumor fluid techniques were applied. While the malignant cell rate was > 95% in 3 of these cases, the cancer-associated fibroblasts (CAF) microenvironment was high in 46 (80-94%) and low in 2 (1-79%). Subtyping of cells obtained from culture was performed using the light microscope and, if necessary, additional immunohistochemical markers. Consequently, using different techniques, here we successfully performed primary cell culture from patients with NSCLC with microenvironment. Depending on the cell type and culture conditions, proliferation rate was shown to be altered.

Vertically oriented self-assembly of colloidal CdSe/CdZnS quantum wells controlled via hydrophilicity/lipophilicity balance: optical gain of quantum well stacks for amplified spontaneous emission and random lasing.

We propose and demonstrate vertically oriented self-assembly of colloidal quantum wells (CQWs) that allows for stacking CdSe/CdZnS core/shell CQWs in films for the purposes of amplified spontaneous emission (ASE) and random lasing. Here, a monolayer of such CQW stacks is obtained via liquid-air interface self-assembly (LAISA) in a binary subphase by controlling the hydrophilicity/lipophilicity balance (HLB), a critical factor for maintaining the orientation of CQWs during their self-assembly. Ethylene glycol, as a hydrophilic subphase, orients the coalition of these CQWs into self-assembled multi-layers in the vertical direction. Stacking CQWs into large micron-sized areas as a monolayer is facilitated by adjusting HLB with diethylene glycol addition as a more lyophilic subphase during LAISA. ASE was observed from the resulting multi-layered CQW stacks prepared via sequential deposition onto the substrate by applying the Langmuir-Schaefer transfer method. Random lasing was achieved from a single self-assembled monolayer of the vertically oriented CQWs. Here, highly rough surfaces resulting from the non-close packing nature of the CQW stack films cause strongly thickness-dependent behavior. We observed that in general a higher roughness-to-thickness ratio of the CQW stack films (e.g., thinner films that are intrinsically rough enough) leads to random lasing, while it is possible to observe ASE only in thick enough films even if their roughness is relatively higher. These findings indicate that the proposed bottom-up technique can be used to construct thickness-tunable, three-dimensional CQW superstructures for fast, low-cost, and large-area fabrication.

Validation of the Turkish version of the Lewy body composite risk score.

The Lewy Body Composite Risk Score (LBCRS) has been developed to increase the sensitivity and specificity of the diagnosis attributable to Lewy body pathology outside of specialty centers. We aimed to assess the validity and reliability of the Turkish version of the LBCRS in patients with dementia with Lewy Bodies (DLB) and investigate the discriminative power of the test in Turkish patients with Alzheimer's disease (AD) and DLB, and control group. The sample population (n = 512) comprised DLB (n = 113), DLB-Mild Cognitive Impairment (MCI)(n = 12), AD (n = 42), AD-MCI (n = 21), and control group (n = 324). A significant group difference was observed in the Turkish version of the LBCRS scores of the five groups (p < .001). The Cronbach's α value was 0.82 (95% CI: 0.799-0.868). The test-retest reliability score of the scale was r = 0.94 and p < .001. The subscales of the LBCRS (motor and nonmotor subdomains of the disease) were determined to explain 65.961% of the total variance with an eigenvalue >1. In patients with DLB, the cutoff score of ≥3 showed sensitivity (92%) and specificity (81%) (area under the curve [AUC] = 0.883, 95% CI: 0.815-0.951), p < .001) compared with the AD. Compared to the control group, the cutoff score of ≥3 showed a sensitivity of 98% and specificity of 97% (AUC = 0.994, 95% CI: 0.989-0.999, p < .001). The Turkish version of LBCRS permits accurate diagnosis of DLB with high sensitivity and specificity. Also, it can be useful to inform the caregivers regarding the course of the disease during the follow-up.

On the Rational Design of Core/(Multi)-Crown Type-II Heteronanoplatelets.

Solution-processed two-dimensional nanoplatelets (NPLs) allowing lateral growth of a shell (crown) by not affecting the pure confinement in the vertical direction provide unprecedented opportunities for designing heterostructures for light-emitting and -harvesting applications. Here, we present a pathway for designing and synthesizing colloidal type-II core/(multi-)crown hetero-NPLs and investigate their optical properties. Stoke's shifted broad photoluminescence (PL) emission and long PL lifetime (∼few 100 ns) together with our wavefunction calculations confirm the type-II electronic structure in the synthesized CdS/CdSe1-xTex core/crown hetero-NPLs. In addition, we experimentally obtained the band-offsets between CdS, CdTe, and CdSe in these NPLs. These results helped us designing hetero-NPLs with near-unity PL quantum yield in the CdSe/CdSe1-xTex/CdSe/CdS core/multicrown architecture. These core/multicrown hetero-NPLs have two type-II interfaces unlike traditional type-II NPLs having only one and possess a CdS ending layer for passivation and efficient suppression of stacking required for optoelectronic applications. The light-emitting diode (LED) obtained using multicrown hetero-NPLs exhibits a maximum luminance of 36,612 cd/m2 and external quantum efficiency of 9.3%, which outcompetes the previous best results from type-II NPL-based LEDs. These findings may enable designs of future advanced heterostructures of NPLs which are anticipated to show desirable results, especially for LED and lasing platforms.

Hyperuricemia may be associated with muscle wellness in older adults.

PURPOSE: Sarcopenia, associated with morbidity and mortality, is a common geriatric syndrome in older adults. In this study, we investigated the relationship between uric acid, which is a powerful antioxidant and has intracellular proinflammatory activity, and sarcopenia in older adults. METHODS: This is a cross-sectional retrospective study involving a total of 936 patients. The diagnosis of sarcopenia was evaluated based on the EGWSOP 2 criteria. The patients were divided into two groups according to hyperuricemia (for females > 6 mg/dl, for males > 7 mg/dl); hyperuricemia and control. RESULTS: The frequency of hyperuricemia was 65.40%. Patients with hyperuricemia were older than the control group and female gender frequency was higher (p = 0.001, p < 0.001, respectively). Sarcopenia was negatively associated with hyperuricemia as a result of the adjustment analysis made according to demographic characteristics, comorbidities, laboratory results, malnutrition, and malnutrition risk. (p = 0.034). Besides, muscle mass and muscle strength were associated with hyperuricemia (p = 0.026 and p = 0.009, respectively). CONCLUSIONS: Considering the positive effect of hyperuricemia on sarcopenia, avoiding aggressive uric acid-lowering therapy may be a good option in older adults with asymptomatic hyperuricemia.

Highly-Directional, Highly-Efficient Solution-Processed Light-Emitting Diodes of All-Face-Down Oriented Colloidal Quantum Well Self-Assembly.

Semiconductor colloidal quantum wells (CQWs) provide anisotropic emission behavior originating from their anisotropic optical transition dipole moments (TDMs). Here, solution-processed colloidal quantum well light-emitting diodes (CQW-LEDs) of a single all-face-down oriented self-assembled monolayer (SAM) film of CQWs that collectively enable a supreme level of IP TDMs at 92% in the ensemble emission are shown. This significantly enhances the outcoupling efficiency from 22% (of standard randomly-oriented emitters) to 34% (of face-down oriented emitters) in the LED. As a result, the external quantum efficiency reaches a record high level of 18.1% for the solution-processed type of CQW-LEDs, putting their efficiency performance on par with the hybrid organic-inorganic evaporation-based CQW-LEDs and all other best solution-processed LEDs. This SAM-CQW-LED architecture allows for a high maximum brightness of 19,800 cd m-2 with a long operational lifetime of 247 h at 100 cd m-2 as well as a stable saturated deep-red emission (651 nm) with a low turn-on voltage of 1.7 eV at a current density of 1 mA cm-2 and a high J90 of 99.58 mA cm-2 . These findings indicate the effectiveness of oriented self-assembly of CQWs as an electrically-driven emissive layer in improving outcoupling and external quantum efficiencies in the CQW-LEDs.

Orthostatic hypotension in dementia with Lewy bodies: a meta-analysis of prospective studies.

PURPOSE: Orthostatic hypotension (OH), one of the supportive clinical features in the diagnosis of dementia with Lewy bodies (DLB), is a significant problem in advanced age because of its severe negative consequences. The aim of this meta-analysis was to investigate the prevalence and risk of OH in patients with DLB. METHODS: The indexes and databases cited to identify relevant studies were PubMed, ScienceDirect, Cochrane, and Web of Science. The keywords for the search were "Lewy body dementia" and "autonomic dysfunction" or "dysautonomia" or "postural hypotension" or "orthostatic hypotension." English-language articles published from January 1990 to April 2022 were searched. The Newcastle-Ottawa scale was applied to evaluate the quality of the studies. Odds ratios (OR) and risk ratios (RR) were extracted with 95% confidence intervals (CI) and combined using the random effects model after logarithmic transformation. The prevalence in the patients with DLB was also combined using the random effects model. RESULTS: Eighteen studies (10 case controls and 8 case series) were included to evaluate the prevalence of OH in patients with DLB. Higher rates of OH were found to be associated with DLB (OR 7.71, 95% CI 4.42, 13.44; p < 0.001), and 50.8% of 662 patients had OH. CONCLUSION: DLB increased the risk of OH by 3.62- to 7.71-fold compared to healthy controls. Therefore, it will be useful to evaluate postural blood pressure changes in the follow-up and treatment of patients with DLB.