The measurement of NRF2 and TP53 in blood expects radiotherapeutic sensitivity in patients with esophageal cancer.

OBJECTIVE: This study investigates the relationship between the mRNA expression of nuclear factor erythroid 2-related factor 2 (NRF2) and Tumor protein p53 (TP53) in circulating tumor cells (CTC) and sensitivity to radiotherapy in patients with esophageal cancer. To investigate the relationship between cytokines IL-6, CD8+, and NRF2 during patient treatment and their predictive role for treatment. METHODS: Radiosensitivity was assessed by measuring a morphological or functional change in the tumor in response to ionizing radiation. Fasting venous anticoagulated blood (EDTA anticoagulation) was drawn from patients, and the Trizol-chloroform two-step method was used for RNA extraction. Data were collected from 45 patients admitted with radiotherapy alone from January 2018 to December 2021. The expression levels of NRF2mRNA (Messenger Ribose Nucleic Acid) and TP53mRNA in CTCs were detected by reverse transcription-polymerase chain reaction (RT-PCR). Pre- and post-treatment changes in IL-6 and CD8+ were recorded. The correlation between their expression level and the clinical stage, radiotherapy sensitivity, and efficacy of patients was analyzed. RESULTS: Twenty-six cases were sensitive to radiotherapy, and 19 were resistant, for a radiotherapy sensitivity rate of 58.8%. NRF2mRNA and TP53mRNA values increased in 19 radiotherapy-resistant patients and decreased in 26 radiotherapy-sensitive patients compared with those before radiotherapy (P = 0.001, P＜0.05). The ΔCT values of NRF2mRNA and TP53mRNA before treatment were moderately correlated with prognosis (P < 0.002). Inflammatory cytokine IL-6 was elevated in 22 of 45 patients after radiation, P = 0.04. NRF2 mRNA level was consistently elevated with CD8+ in 10 patients, P = 0.02. CONCLUSIONS: The expression of NRF2mRNA and TP53mRNA in the CTCs found in the peripheral blood of patients with esophageal squamous carcinoma was significantly associated with the sensitivity to radiotherapy. NRF2 mRNA level was consistently elevated with CD8+ and IL-6 in patients.

Perceived uncertainty stress and its predictors among residents in China during the COVID-19 pandemic.

The prevalence of and risk factors for uncertainty stress among residents during the COVID-19 pandemic remain unclear. An online cross-sectional survey was conducted to explore and identify the risk factors for high perceived uncertainty stress among the general public in China during the COVID-19 outbreak. Information about the respondents' socioeconomic characteristics, knowledge of and attitudes towards COVID-19, perceived uncertainty stress, social capital, anxiety, and depressive symptoms was collected and analysed. Among the 1205 respondents, 45.3% (546) reported a high level of uncertainty stress. Multiple linear regression analysis indicated that anxiety (ß=3.871,P<0.001) and depression symptoms (ß=2.458, P<0.001), family residence (in towns or rural areas) (ß=0.947, P<0.001), lack of support for local epidemic control strategies (ß=1.253, P<0.001), worry about the pandemic (ß=1.191, P<0.001), and symptoms of weakness among family members (ß=1.525, P=0.002) were positively associated with perceived uncertainty stress. Cognitive social capital (ß=-0.883, P<0.001) and social networks (ß=-0.726, P<0.001) were negatively, but social participation (ß=0.714, P<0.001) was positively associated with perceived uncertainty stress. Our findings identify factors associated with a higher level of uncertainty stress and should be helpful in the consideration of effective policies and interventions for uncertainty stress during the initial phases of public health emergencies.

A Light Harvesting Complex-Like Protein in Maintenance of Photosynthetic Components in Chlamydomonas.

Using a genetic approach, we have identified and characterized a novel protein, named Msf1 (Maintenance factor for photosystem I), that is required for the maintenance of specific components of the photosynthetic apparatus in the green alga Chlamydomonas reinhardtii Msf1 belongs to the superfamily of light-harvesting complex proteins with three transmembrane domains and consensus chlorophyll-binding sites. Loss of Msf1 leads to reduced accumulation of photosystem I and chlorophyll-binding proteins/complexes. Msf1is a component of a thylakoid complex containing key enzymes of the tetrapyrrole biosynthetic pathway, thus revealing a possible link between Msf1 and chlorophyll biosynthesis. Protein interaction assays and greening experiments demonstrate that Msf1 interacts with Copper target homolog1 (CHL27B) and accumulates concomitantly with chlorophyll in Chlamydomonas, implying that chlorophyll stabilizes Msf1. Contrary to other light-harvesting complex-like genes, the expression of Msf1 is not stimulated by high-light stress, but its protein level increases significantly under heat shock, iron and copper limitation, as well as in stationary cells. Based on these results, we propose that Msf1 is required for the maintenance of photosystem I and specific protein-chlorophyll complexes especially under certain stress conditions.

Systematically ranking the tightness of membrane association for peripheral membrane proteins (PMPs).

Large-scale quantitative evaluation of the tightness of membrane association for nontransmembrane proteins is important for identifying true peripheral membrane proteins with functional significance. Herein, we simultaneously ranked more than 1000 proteins of the photosynthetic model organism Synechocystis sp. PCC 6803 for their relative tightness of membrane association using a proteomic approach. Using multiple precisely ranked and experimentally verified peripheral subunits of photosynthetic protein complexes as the landmarks, we found that proteins involved in two-component signal transduction systems and transporters are overall tightly associated with the membranes, whereas the associations of ribosomal proteins are much weaker. Moreover, we found that hypothetical proteins containing the same domains generally have similar tightness. This work provided a global view of the structural organization of the membrane proteome with respect to divergent functions, and built the foundation for future investigation of the dynamic membrane proteome reorganization in response to different environmental or internal stimuli.

Functional proteomic discovery of Slr0110 as a central regulator of carbohydrate metabolism in Synechocystis species PCC6803.

The unicellular photosynthetic model-organism cyanobacterium Synechocystis sp. PCC6803 can grow photoautotrophically using CO2 or heterotrophically using glucose as the sole carbon source. Several pathways are involved in carbon metabolism in Synechocystis, and the concerted regulation of these pathways by numerous known and unknown genes is critical for the survival and growth of the organism. Here, we report that a hypothetical protein encoded by the open reading frame slr0110 is necessary for heterotrophic growth of Synechocystis. The slr0110-deletion mutant is defective in glucose uptake, heterotrophic growth, and dark viability without detectable defects in autotrophic growth, whereas the level of photosystem II and the rate of oxygen evolution are increased in the mutant. Quantitative proteomic analysis revealed that several proteins in glycolysis and the oxidative pentose phosphate pathway are down-regulated, whereas proteins in photosystem II and phycobilisome are significantly up-regulated, in the mutant. Among the down-regulated proteins are glucose transporter, glucokinase, glucose-6-phosphate isomerase, and glucose-6-phosphate dehydrogenase and its assembly protein OpcA, suggesting that glycolysis, oxidative pentose phosphate, and glycogen synthesis pathways are significantly inhibited in the mutant, which was further confirmed by enzymatic assays and quantification of glycogen content. These findings establish Slr0110 as a novel central regulator of carbon metabolism in Synechocystis, and shed light on an intricate mechanism whereby photosynthesis and carbon metabolism are well concerted to survive the crisis when one or more pathways of the system are impaired.

Phosphorylation-coupled proteolysis of the transcription factor MYC2 is important for jasmonate-signaled plant immunity.

As a master regulator of jasmonic acid (JA)-signaled plant immune responses, the basic helix-loop-helix (bHLH) Leu zipper transcription factor MYC2 differentially regulates different subsets of JA-responsive genes through distinct mechanisms. However, how MYC2 itself is regulated at the protein level remains unknown. Here, we show that proteolysis of MYC2 plays a positive role in regulating the transcription of its target genes. We discovered a 12-amino-acid element in the transcription activation domain (TAD) of MYC2 that is required for both the proteolysis and the transcriptional activity of MYC2. Interestingly, MYC2 phosphorylation at residue Thr328, which facilitates its turnover, is also required for the MYC2 function to regulate gene transcription. Together, these results reveal that phosphorylation-coupled turnover of MYC2 stimulates its transcription activity. Our results exemplify that, as with animals, plants employ an "activation by destruction" mechanism to fine-tune their transcriptome to adapt to their ever-changing environment.

[Study on the Effects of Alq3:CsF Composite Cathode Buffer Layer on the Performances of CuPc/C60 Solar Cells].

This paper introduces the methods improving the performance and stability of copper-phthalocyanine(CuPc) / fullerene (C60) small molecule solar cells by using tris-(8-hydroxyquinoline) aluminum(Alq3): cesium fluoride(CsF) composite cathode buffer layer. The device with Alq3:CsF composite cathode buffer layer with a 4 wt. % CsF at a thickness of 5 nm exhibits a power conversion efficiency (PCE) of up to 0.76%, which is an improvement of 49%, compared to a device with single Alq3 cathode buffer layer and half-lifetime of the cell in air at ambient circumstance without any encapsulation is almost 9.8 hours, 6 times higher than that of without buffer layer, so the stability is maintained. The main reason of the device performance improvement is that doping of CsF can adjust the interface energy alignment, optimize the electronic transmission characteristics of Alq3 and improve the short circuit current and the fill factor of the device using ultraviolet-visible absorption, external quantum efficiency and single-electron devices. Placed composite cathode buffer layer devices with different time in the air, by comparing and analyzing current voltage curve, Alq3:CsF can maintain a good stability as Alq3. Alq3:CsF layer can block the diffusion of oxygen and moisture so completely as to improve the lifetime of the device.

Delayed Administration of Tat-HA-NR2B9c Promotes Recovery After Stroke in Rats.

BACKGROUND AND PURPOSE: Previous studies reported that Tat-NR2B9c, a peptide disrupting the N-methyl-d-aspartate receptor-postsynaptic density protein-95 interaction, reduced ischemic damage in the acute phase after stroke. However, its effect in the subacute phase is unknown. The aim of this study is to determine whether disrupting the N-methyl-d-aspartate receptor-postsynaptic density protein-95 interaction in the subacute phase promotes recovery after stroke. METHODS: Studies were performed on Sprague-Dawley rats or nNOS(-/-) mice, and experimental ischemic stroke was induced by middle cerebral artery occlusion. Animals were treated with drugs starting at day 4 after ischemia. Sensorimotor functions and spatial learning and memory ability were assessed after drug treatment. Then, rats were euthanized for morphological observation and biochemical tests. RESULTS: Disrupting the N-methyl-d-aspartate receptor-postsynaptic density protein-95 interaction with Tat-HA-NR2B9c significantly ameliorated the ischemia-induced impairments of spatial memory and sensorimotor functions in rats during subacute stage but did not improve stroke outcome in nNOS(-/-) mice. Consistent with the functional recovery, Tat-HA-NR2B9c substantially increased neurogenesis in the dentate gyrus and dendritic spine density of mature neurons in the motor cortex of rats, meanwhile, reversed the ischemia-induced formation of S-nitrosylation-cyclin-dependent kinase 5 and increased cyclin-dependent kinase 5 activity in ipsilateral hippocampus. However, directly blocking N-methyl-d-aspartate receptors with MK-801 or Ro 25-6981 did not show the beneficial effects above. CONCLUSIONS: Dissociating N-methyl-d-aspartate receptor-postsynaptic density protein-95 coupling by Tat-HA-NR2B9c in the subacute phase after stroke promotes functional recovery, probably because of that it increases neurogenesis and dendritic spine density of mature neurons via regulating cyclin-dependent kinase 5 in the ischemic brain.

Toward the complete proteome of Synechocystis sp. PCC 6803.

The proteome of the photosynthetic model organism Synechocystis sp. PCC 6803 has been extensively analyzed in the last 15 years for the purpose of identifying proteins specifically expressed in subcellular compartments or differentially expressed in different environmental or internal conditions. This review summarizes the progress achieved so far with the emphasis on the impact of different techniques, both in sample preparation and protein identification, on the increasing coverage of proteome identification. In addition, this review evaluates the current completeness of proteome identification, and provides insights on the potential factors that could affect the complete identification of the Synechocystis proteome.

Risk factors and safe dosage of levodopa for wearing-off phenomenon in Chinese patients with Parkinson's disease.

The objective of this study was to investigate the risk factors of wearing-off phenomenon in Parkinson's disease (PD) and propose safe dosage of levodopa to reduce wearing-off development based on Chinese cohort. Patients with PD who had taken levodopa (L-dopa) for at least 1 month were recruited. Wearing-off was diagnosed based on validated Chinese version of a patient self-rated 9-question Wearing-Off Questionnaire (WOQ-9) and clinical definition. Eleven variables (gender, disease duration at L-dopa initiation, disease duration at assessment, age at onset, age at assessment, H-Y stage, UPDRS III, L-dopa daily total dosage and dosage adjusted to weight, duration of L-dopa treatment, initial drug recipe) were included in our analysis. Univariate analysis, multivariate logistic regression analysis and decision tree classification model(DTC) were used to detect risk factors of wearing-off. Receiver operating characteristic (ROC) curve and DTC were used to investigate cut-off value of L-dopa to best predict wearing-off. Two hundred and thirty-four patients were investigated in our study, among whom 111 developed wearing-off. Patients with wearing-off tended to receive higher L-dopa dosage and endure longer duration of L-dopa treatment. L-Dopa dosage as 281 mg/day and 4.2 mg/kg/day by ROC, as well as 269 mg/day and 3.2 mg/kg/day by DTC were cut-off values for wearing-off. L-Dopa dosage and duration of L-dopa treatment were related to increased wearing-off development. Cumulative L-dopa dosage and L-dopa daily dosage were better predictive of wearing-off. Inadequate evidence was present for delayed L-dopa initiation. L-Dopa daily dosage no more than 275 mg or 4.2 mg/kg was regarded as safe.

The diagnostic value of minor salivary gland biopsy in clinically diagnosed patients with Parkinson's disease: comparison with DAT PET scans.

To investigate the predictive value of minor salivary gland biopsy in clinically diagnosed early stage Parkinson's disease (PD) patients, and to provide more evidence of minor salivary gland biopsy as a pathological diagnostic biomarker of PD. Thirteen patients with early stage PD and 13 age-matched controls were recruited. Hoehn and Yahr stage and Unified Parkinson's disease Rating Scale Part III were employed to evaluate their severity of the disease. All the subjects underwent minor salivary gland biopsy and (11)C-methyl-N-2ß-carbomethoxy-3ß-(4-fluorophenyl) tropane ((11)C-CFT) DAT-PET scan. Immunohistochemical staining for Lewy-type alpha-synucleinopathy using antibody against alpha-synuclein (α-Syn) was performed in the tissues obtained from minor salivary gland. Abnormal accumulation of α-Syn was found around the gland cells in 9 of the 13 patients with PD, but in none of the control subjects. The α-Syn immunoreactive structures were located in the periacinar space. Twelve clinically diagnosed PD patients showed asymmetrical and relatively severe reduction of (11)C-CFT uptake in the posterior putamen compared with the control. The sensitivity, specificity, positive predictive value and negative predictive value of minor salivary gland biopsy were 75, 100, 100 and 25%, respectively, when compared with the DAT-PET imaging. Our results suggest that minor salivary gland biopsy does not hold high diagnostic accuracy as DAT-PET, but still has the potential to be a useful pathologic biomarker for PD, which is worth more investigations.

Cardiovascular risk factors in CKD associate with both ESRD and mortality.

The American Heart Association's Life's Simple 7 initiative allows individuals to assess health factors (BP, cholesterol, and glucose) and health behaviors (cigarette smoking, physical activity, diet, and body mass index) to promote improved cardiovascular health. Because several cardiovascular risk factors also associate with progressive kidney disease, Life's Simple 7 may also inform an individual's risk for ESRD. Here, we investigated the association of Life's Simple 7 components with both ESRD incidence and all-cause mortality among 3093 participants with an estimated GFR (eGFR) <60 ml/min per 1.73 m(2) from the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. During a median 4 years of follow-up, 160 participants developed ESRD, and 610 participants died. Compared with individuals who had zero or one of the Life's Simple 7 components in the ideal range, those individuals with two, three, and four ideal factors had progressively lower risks for ESRD; furthermore, no participant with five to seven ideal factors developed ESRD. The risk for all-cause mortality exhibited a similar trend. Adjusting for eGFR and albuminuria, however, completely attenuated the associations between the number of ideal factors and the risks for both ESRD and all-cause mortality. In conclusion, a favorable cardiovascular risk profile among individuals with CKD associates with a reduced risk for ESRD and mortality, but whether the severity of kidney disease confounds or mediates this association requires additional investigation.

Glaucoma medication adherence among African Americans: program development.

PURPOSE: To elucidate barriers and facilitators related to glaucoma medication adherence among African Americans (AA) with glaucoma and to elicit input from a community-based participatory research team to guide the development of a culturally informed health promotion program for improving glaucoma medication adherence among AAs. METHODS: The nominal group technique (NGT), a highly structured focus group methodology, was implemented with 12 separate groups of AA patients with glaucoma (N = 89) to identify barriers and facilitators related to glaucoma medication usage. Participant rank-ordering votes were summed across groups and categorized into themes. Next, an individually and culturally targeted health promotion program promoting appropriate medication adherence was developed based on focus group results and input from a community-based participatory research team. RESULTS: The top five barriers included problems with forgetfulness, side effects, cost/affordability, eyedrop administration, and the eyedrop schedule. The most salient top five facilitators were fear or thoughts about the consequences of not taking eyedrops; use of memory aids, cues, or strategies; maintaining a regular routine or schedule for eyedrop administration; ability to afford eyedrops; and keeping eyedrops in the same area. The resulting health promotion program was based on a multicomponent empowerment framework that included glaucoma education, motivational interviewing, and problem-solving training to improve glaucoma medication adherence. CONCLUSIONS: Barriers and facilitators related to glaucoma medication adherence among AAs are multifactorial. Based on the NGT themes and input from the community-based participatory research team, a culturally informed health promotion program was designed and holds great promise for improving medication adherence among this vulnerable population.

Chloride Transport and Related Influencing Factors of Alkali-Activated Materials: A Review.

Chloride transport is a vital issue in the research on the durability of alkali-activated materials (AAMs). Nevertheless, due to its miscellaneous types, complex mix proportions, and limitations in testing methods, the reports of different studies are numerous and vary greatly. Therefore, in order to promote the application and development of AAMs in chloride environments, this work systematically reviews the chloride transport behavior and mechanism, solidification of chloride, influencing factors, and test method of chloride transport of AAMs, along with conclusions regarding instructive insights to the chloride transport problem of AAMs in future work.

Length bias correction for RNA-seq data in gene set analyses.

MOTIVATION: Next-generation sequencing technologies are being rapidly applied to quantifying transcripts (RNA-seq). However, due to the unique properties of the RNA-seq data, the differential expression of longer transcripts is more likely to be identified than that of shorter transcripts with the same effect size. This bias complicates the downstream gene set analysis (GSA) because the methods for GSA previously developed for microarray data are based on the assumption that genes with same effect size have equal probability (power) to be identified as significantly differentially expressed. Since transcript length is not related to gene expression, adjusting for such length dependency in GSA becomes necessary. RESULTS: In this article, we proposed two approaches for transcript-length adjustment for analyses based on Poisson models: (i) At individual gene level, we adjusted each gene's test statistic using the square root of transcript length followed by testing for gene set using the Wilcoxon rank-sum test. (ii) At gene set level, we adjusted the null distribution for the Fisher's exact test by weighting the identification probability of each gene using the square root of its transcript length. We evaluated these two approaches using simulations and a real dataset, and showed that these methods can effectively reduce the transcript-length biases. The top-ranked GO terms obtained from the proposed adjustments show more overlaps with the microarray results. AVAILABILITY: R scripts are at http://www.soph.uab.edu/Statgenetics/People/XCui/r-codes/.

Low income and albuminuria among REGARDS (Reasons for Geographic and Racial Differences in Stroke) study participants.

BACKGROUND: Albuminuria is an important risk factor for progressive chronic kidney disease (CKD) and is more prevalent in black than white adults. We sought to determine the association between low income and albuminuria and whether this association differs for blacks and whites. STUDY DESIGN: Cross-sectional study. SETTING & PARTICIPANTS: 9,144 black and 13,684 white US adults 45 years and older in the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. PREDICTORS: Self-reported annual household income category (≥$75,000, $35,000-$74,999, $20,000-$34,999, and <$20,000); black and white race. OUTCOMES & MEASUREMENTS: Albuminuria defined as high (30-300 mg/g) or very high (>300 mg/g) urinary albumin-creatinine ratio (ACR). Multinomial logistic regression used to examine the race-stratified association between categories of income and albuminuria (normal, high, or very high ACR). RESULTS: Overall, geometric mean ACR was 10.2 mg/g and was higher for blacks (11.8 mg/g) than whites (9.3 mg/g), P<0.001. Lower income was associated with a higher prevalence of albuminuria for both whites and blacks in unadjusted analyses. After adjustment for demographics, lifestyle factors, comorbid illnesses, and estimated glomerular filtration rate, there was a trend toward a stronger association between lower income levels and high ACR in blacks (ORs of 1.38 [95% CI, 1.07-1.77], 1.36 [95% CI, 1.05-1.75], and 1.58 [95% CI, 1.21-2.05] for income levels of $35,000-$74,999, $20,000-$34,999, and <$20,000, respectively; reference group is those with income≥$75,000) compared with whites (ORs of 0.95 [95% CI, 0.81-1.12], 0.95 [95% CI, 0.79-1.14], and 1.26 [95% CI, 1.02-1.55], respectively); P interaction=0.08 between race and income. Results were similar for very high ACR and subgroups of participants with diabetes or hypertension. LIMITATIONS: Cross-sectional design; not all REGARDS participants provided their annual income. CONCLUSIONS: Lower income may be associated more strongly with albuminuria in blacks than whites and may be a determinant of racial disparities in albuminuria.

Use of prescribed optical devices in age-related macular degeneration.

PURPOSE: To evaluate prescribed optical device use in terms of frequency and perceived usefulness among people with age-related macular degeneration (AMD). We also sought to determine the tasks for which they were using their prescribed low vision device(s). METHODS: One hundred ninety-nine patients with AMD presenting for the first time to the low vision service were recruited from a university-based clinic. Prior to the low vision evaluation and device prescription, they completed the National Eye Institute Visual Function Questionnaire 25, Center for Epidemiological Studies Depression Scale, Short Portable Mental Status Questionnaire, and a general health questionnaire. The low vision evaluation included best-corrected Early Treatment of Diabetic Retinopathy Study visual acuity, MNREAD testing, microperimetry, prescription, and dispensing of optical low vision devices. Telephone follow-up interviews were conducted about device usage 1-week, 1-month, and 3-months postintervention. RESULTS: One hundred eighty-one participants were prescribed low vision devices. Of them, 93% completed all 3 follow-up interviews. Intensive users (≥1 hours/day) of devices were similar in demographic and visual characteristics to non-intensive users (<1 hours/day), except for habitual reading acuity and speed as well as contrast sensitivity. Overall, device use increased slightly over 3 months of follow-up. Magnifiers were reported to be moderately-to-extremely useful by >80% of participants at all time points except the 1-month follow-up for hand magnifiers (75%). High plus spectacles were the least frequently prescribed device and rated as moderately-to-extremely useful by 70%, 74%, and 59% at 1 week, 1 month, and 3 months, respectively. Most participants used their devices for leisure reading, followed by managing bills. Very few devices (n = 3, <1%) were not used at any time point. CONCLUSIONS: Patients with AMD who are provided with prescribed optical low vision devices do use them and perceive them as useful, especially for leisure reading activities. High rates of usage were maintained over 3 month.

Proteomic analysis of albumins and globulins from wheat variety Chinese Spring and its fine deletion line 3BS-8.

The relationship between chromosome deletion in wheat and protein expression were investigated using Chinese Spring and fine deletion line 3BS-8. Through 2-DE (2-D electrophoresis) analysis, no differentially expressed proteins (DEPs) were found in leaf samples; however, 47 DEPs showed at least two-fold abundance variation (p < 0.05) in matured wheat grains and 21 spots were identified by tandem MALDI-TOF/TOF-MS. Among the identified spots, four were cultivar-specific, including three (spots B15, B16, and B21) in Chinese Spring and one in 3BS-8 (spot B10). Among variety-different DEPs between Chinese Spring and 3BS-8, most spots showed a higher express profile in CS; only four spots showed up-regulated expression tendency in 3BS-8. An interesting observation was that more than half of the identified protein spots were involved in storage proteins, of which 11 spots were identified as globulins. According to these results, we can presume that the encoded genes of protein spots B15, B16, and B21 were located on the chromosome segment deleted in 3BS-8.

What stroke symptoms tell us: association of risk factors and individual stroke symptoms in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.

BACKGROUND: Stroke symptoms are common among people without a history of stroke or transient ischemic attack; however, it is unknown if particular attention should be focused on specific symptoms for subgroups of patients. METHODS: Using baseline data from 26,792 REasons for Geographic And Racial Differences in Stroke (REGARDS) participants without a history of transient ischemic attack or stroke, we assessed the association between age, sex, race, current smoking, hypertension, and diabetes and the 6 stroke symptoms in the Questionnaire for Verifying Stroke-Free Status. RESULTS: The mean age of participants was 64.4 ± 9.4 years, 40.7% were black, and 55.2% were women. After multivariable adjustment, older persons more often reported an inability to understand (odds ratio [OR] 1.16 per 10 years older age; 95% confidence interval [CI] 1.07-1.25) and unilateral vision loss (OR 1.09; 95% CI 1.01-1.18) and less often reported numbness (OR 0.83; 95% CI 0.79-0.87) and weakness (OR 0.85; 95% CI 0.80-0.90). Women reported difficulty communicating more often than men (OR 1.36; 95% CI 1.19-1.56). The OR for blacks compared to whites for each of the 6 stroke symptoms was increased, markedly so for unilateral numbness (OR 1.97; 95% CI 1.81-2.16), unilateral weakness (OR 1.96; 95% CI 1.76-2.18), and inability to understand (OR 1.87; 95% CI 1.61-2.18). Current smoking, hypertension, and diabetes were associated with higher ORs for each stroke symptom. CONCLUSIONS: The association of risk factors with 6 individual stroke symptoms studied was not uniform, suggesting the need to emphasize individual stroke symptoms in stroke awareness campaigns when targeting populations defined by risk.

Erythrocytic alpha-synuclein in early Parkinson's disease: A 3-year longitudinal study.

BACKGROUND: Early diagnosis of Parkinson's disease (PD) could significantly improve outcomes for patients and future disease-modifying treatments. Several studies have revealed that α-synuclein levels in peripheral erythrocytes are associated with PD, but the diagnostic value in early PD is still unknown. METHODS: This study included both cross-sectional and longitudinal design. The subjects included 45 patients with early PD and 79 age-matched healthy controls. Participants were re-examined with repeated blood collection and clinical assessments after 3 years. The electrochemiluminescence assay was used to measure total and oligomeric α-synuclein levels respectively. The diagnostic value of erythrocytic α-synuclein for early PD was determined by receiver operator characteristic (ROC) curve. Correlations between RBC α-synuclein levels and changes over 3 years in clinical characteristic scores were further investigated with a linear regression. RESULTS: Total and oligomeric α-synuclein levels in erythrocyte were significantly increased in early PD groups compared with control group (Total α-synuclein, p < 0.001; Oligomer, p < 0.001). Levels of total and oligomeric α-synuclein in erythrocytes were correlated with MDS-UPDRS III scores in early PD (Total α-synuclein, p = 0.008; Oligomer, p = 0.037). After adjusting for age, gender and dopaminergic medication, an association was found between higher erythrocytic oligomeric α-synuclein levels at baseline and greater increase in MDS-UPDRS III scores over 3 years (p = 0.007). CONCLUSION: Our study suggests that total and oligomeric α-synuclein in erythrocyte were elevated even in the initial motor stage of PD. Higher erythrocytic oligomeric α-synuclein levels at baseline predicts a faster clinical decline over time in patients with early PD.