White matter tract density index is associated with disability in multiple sclerosis.

BACKGROUND: The association between common neuroradiological markers of multiple sclerosis (MS) and clinical disability is weak. Given that the disability in patients with MS may depend on the underlying structural connectivity of the brain, our study aimed to examine the association between white matter tracts affected by MS and the patients' disability using a new tract density index (TDI). METHOD: This study included 53 patients diagnosed with MS, examined between 2019 and 2020. Manual lesion segmentation was performed on fluid-attenuated inversion recovery (FLAIR) images, and the density of white matter tracts encompassing the lesion (i.e., TDI) was calculated. Correlation analysis was employed to assess the association between TDI and disability. Additionally, the relationship between disability, TDI, and lesion-derived network metrics was examined by computing a partial correlation network. RESULTS: The TDI significantly correlated with the expanded disability status scale (EDSS) (r = 0.30, p = 0.03). Furthermore, the patient's disability is linked solely through TDI to lesion-derived network metrics -a key metric that 'bridges' the gap between the brain lesion and disability. CONCLUSIONS: In this study, MS lesions encompassing regions with high white matter tract density were associated and linked with severe physical disability. These findings indicate that TDI may be an outcome predictor that may connect radiologic findings to clinical practice.

Drosophila HCN mediates gustatory homeostasis by preserving sensillar transepithelial potential in sweet environments.

Establishing transepithelial ion disparities is crucial for sensory functions in animals. In insect sensory organs called sensilla, a transepithelial potential, known as the sensillum potential (SP), arises through active ion transport across accessory cells, sensitizing receptor neurons such as mechanoreceptors and chemoreceptors. Because multiple receptor neurons are often co-housed in a sensillum and share SP, niche-prevalent overstimulation of single sensory neurons can compromise neighboring receptors by depleting SP. However, how such potential depletion is prevented to maintain sensory homeostasis remains unknown. Here, we find that the Ih-encoded hyperpolarization-activated cyclic nucleotide-gated (HCN) channel bolsters the activity of bitter-sensing gustatory receptor neurons (bGRNs), albeit acting in sweet-sensing GRNs (sGRNs). For this task, HCN maintains SP despite prolonged sGRN stimulation induced by the diet mimicking their sweet feeding niche, such as overripe fruit. We present evidence that Ih-dependent demarcation of sGRN excitability is implemented to throttle SP consumption, which may have facilitated adaptation to a sweetness-dominated environment. Thus, HCN expressed in sGRNs serves as a key component of a simple yet versatile peripheral coding that regulates bitterness for optimal food intake in two contrasting ways: sweet-resilient preservation of bitter aversion and the previously reported sweet-dependent suppression of bitter taste.

Optimizing Contact Between Older Adults and Senior Services: South Korean users' Perceptions of Gateway Institutions.

In response to the growing need for effective policy implementation strategies for older adults in South Korea, we propose the establishment of a user-centered institution tightly integrated with policies, termed, "comprehensive gateway institution for older adults." This research addresses the challenges 231 older adult users face when navigating various health policies. Our survey findings revealed that these users experienced difficulties in dealing with the current policy approach for older adults. The respondents expressed their expectations for improved service access through the proposed gateway institution. They emphasized the importance of universal access to services and the need for personalized offerings that consider their unique circumstances, physical abilities, and skills. By incorporating these research outcomes into practice, we can help lay the groundwork for more effective policies measures and create a system that better meets the needs of older adults in the future.

Accuracy of low dose CT in the diagnosis of appendicitis in childhood and comparison with USG and standard dose CT / Precisão de tomografia computadorizada (TC) de baixa dosagem no diagnóstico de apendicite na infância e comparação com ultrassonografia e TC de dosagem padrão

Abstract Objectives: Computed tomography should be performed after careful consideration due to radiation hazard, which is why interest in low dose CT has increased recently in acute appendicitis. Previous studies have been performed in adult and adolescents populations, but no studies have reported on the efficacy of using low-dose CT in children younger than 10 years. Methods: Patients (n = 475) younger than 10 years who were examined for acute appendicitis were recruited. Subjects were divided into three groups according to the examinations performed: low-dose CT, ultrasonography, and standard-dose CT. Subjects were categorized according to age and body mass index (BMI). Results: Low-dose CT was a contributive tool in diagnosing appendicitis, and it was an adequate method, when compared with ultrasonography and standard-dose CT in terms of sensitivity (95.5% vs. 95.0% and 94.5%, p = 0.794), specificity (94.9% vs. 80.0% and 98.8%, p = 0.024), positive-predictive value (96.4% vs. 92.7% and 97.2%, p = 0.019), and negative-predictive value (93.7% vs. 85.7% and 91.3%, p = 0.890). Low-dose CT accurately diagnosed patients with a perforated appendix. Acute appendicitis was effectively diagnosed using low-dose CT in both early and middle childhood. BMI did not influence the accuracy of detecting acute appendicitis on low-dose CT. Conclusion: Low-dose CT is effective and accurate for diagnosing acute appendicitis in childhood, as well as in adolescents and young adults. Additionally, low-dose CT was relatively accurate, irrespective of age or BMI, for detecting acute appendicitis. Therefore, low-dose CT is recommended for assessing children with suspected acute appendicitis.

Resumo Objetivos: A tomografia computadorizada deve ser feita após cautelosa consideração devido ao perigo de radiação, motivo pelo qual o interesse na TC de baixa dosagem tem aumentado recentemente em casos de apendicite aguda. Estudos anteriores foram feitos em populações adultas ou adolescentes, porém nenhum relatou a eficácia do uso da TC de baixa dosagem em crianças com menos de 10 anos. Métodos: Recrutamos pacientes (n = 475) com menos de 10 anos examinados com relação a apendicite aguda. Os indivíduos foram divididos em três grupos de acordo com os exames feitos: TC de baixa dosagem, ultrassonografia e TC de dosagem padrão. Os indivíduos foram categorizados de acordo com a idade e o índice de massa corporal. Resultados: A TC de baixa dosagem foi uma ferramenta de grande contribuição no diagnóstico de apendicite e um método adequado em comparação com a ultrassonografia e a TC de dosagem padrão em termos de sensibilidade (95,5% em comparação com 95% e 94,5%, p = 0,794), especificidade (94,9% em comparação com 80% e 98,8%, p = 0,024), valor preditivo positivo (96,4% em comparação com 92,7% e 97,2%, p = 0,019) e valor preditivo negativo (93,7% em comparação com 85,7% e 91,3%, p = 0,890). A TC de baixa dosagem diagnosticou de forma precisa pacientes com um apêndice perfurado. A apendicite aguda foi diagnosticada de maneira efetiva com a TC de baixa dosagem tanto na primeira quanto na segunda infância. O IMC não influenciou a precisão da detecção de apendicite aguda na TC de baixa dosagem. Conclusão: A TC de baixa dosagem é eficaz e precisa no diagnóstico de apendicite aguda na infância, bem como em adolescentes e jovens adultos. Além disso, a TC de baixa dosagem foi relativamente precisa, independentemente de idade ou IMC, na detecção de apendicite aguda. Assim, a TC de baixa dosagem é recomendada na avaliação de crianças com suspeita de apendicite aguda.