Preliminary Report Research Articles

Optical Coherence Tomography Angiography in the Evaluation of Macular Retinal Microvasculature in Patients in the Early Clinical Stage of Alzheimer’s Disease – A Preliminary Report

IntroductionAlzheimer’s disease (AD) is a chronic neurodegenerative condition causing cognitive decline among elderly individuals. In addition to neurological deficits, a key role in the onset and subsequent progression of AD Alzheimer’s disease-specific changes is attributed to vascular factors. Retinal microvasculature and cerebral small vessels share similar anatomical features and physiological characteristics, and damage to the retinal vascular bed can be observed at any stage of AD Alzheimer’s disease. Retinal microvasculature can be visualized and assessed non-invasively using the technique of optical coherence tomography angiography (OCT-A).Aim of studyEvaluation of macular retinal microvasculature in the superficial capillary plexus based on OCT-A optical coherence tomography angiography images in patients diagnosed with the mild stage of Alzheimer’s dementia.Material and methodsThe study involved a total of 21 patients diagnosed with mild Alzheimer’s dementia confirmed by neuropsychological tests and neuroimaging studies. optical coherence tomography angiography OCT-A was used to determine vessel density in the superficial retinal capillary plexus (SRCP), i.e. generate a density map within five-field ETDRS circles with diameters of 3 mm and 6 mm.ResultsAlterations in the macular retinal capillary network were noted in all eyes studied. In the majority of eyes, there was a marked reduction in vessel density reflected in the quantitative metrics in the density map around the FAZ in at least one of the scans obtained for a given eye (3 mm x 3 mm and/ or 6 mm x 6 mm) and in the macroscopic evaluation of the superficial and deep capillary plexuses, capillary thinning, and irregular area/mexpansion of the FAZ.ConclusionsOptical coherence tomography angiography OCT-A has the potential to serve as a valuable tool for screening or monitoring the response to therapies in patients with Alzheimer’s disease AD. However, further research is necessary to standardize study methodologies and determine whether impaired retinal microvasculature in patients with Alzheimer-type MCI or preclinical Alzheimer’s disease AD correlates with the advancement of cognitive decline and loss of neurons and cerebral blood vessels in individual Alzheimer’s disease AD patients and, hence, has clinical utility.

Cone-Beam Computed Tomography to evaluate changes in trabecular lower jawbone microstructure caused by bone loss and antiresorptive treatment.

The aim of this preliminary report is to evaluate the usefulness of CBCT to assess trabecular mandible microstructural properties in normal ewes and to compare the quantitative changes associated with ovariectomy and antiresorptive treatment. Twelve adult Corriedale ewes (n=4/group) aged 3-4 years were divided into 3 groups and studied for 28 months. Eight ewes were ovariectomized (OVX) and divided into OVX and OVX+ZOL groups (n=4/group) which were treated as follows, by jugular injection: OVX received saline solution and OVX+ZOL received zoledronate (Zol) (Gador SA, CABA, Argentina) (4 mg/month). Another four ewes were subjected to sham surgery (SHAM group) and received saline solution. Densitometry showed that jaw mineral content (BMC) and density (BMD) were significantly lower in OVX than in SHAM and OVX+ZOL ewes; no difference was observed between OVX+ ZOL and SHAM groups. CBCT analysis showed that bone volume (BV/TV%); trabecular thickness (TbTh); connectivity density (CD) and anisotropy degree (AD) were significantly lower, and trabecular spacing (TbSp), significantly higher in OVX than in SHAM ewes. AD was significantly higher and TbSp significantly lower in OVX+ZOL than in OVX groups. BV/TV%, TbTh and CD showed a clear tendency to being higher in OVX+ZOL than in OVX groups. No statistical difference was observed between OVX+ZOL and SHAM ewes. CBCT in a nondestructive, fast, very precise procedure for measuring bone morphometric indices without biopsies, which are not indicated for morphometric evaluation in osteoporosis. The current study demonstrated the potential of the high-resolution CBCT imaging to assess in vivo quantitative bone morphometry and bone quality of lower jaw cancellous bone under normal conditions and to differentiate changes associated with excessive bone loss induced by estrogen withdrawal and antiresorptive intervention.

Sorbent functionalization with vancomycin enhances bacteria killing in extracorporeal hemoadsorption.

The level of bacteremia in patients with sepsis and septic shock is a predictor of complications and mortality, regardless of the type of bacteria. Devices for bacteria, endotoxin and cytokines removal by adsorption have been recently developed. Thus, extracorporeal blood purification therapies have been proposed as adjunctive therapy in sepsis in combination with drugs. Some potentially useful drugs, however, are precluded due to their organ or metabolic toxicity. The present study represents a preliminary report on the invitro effect of a sorbent device (minimodule with HA380 beads, Jafron medical, Zhuhai, China) in which the particles have been functionalized with vancomycin on the surface. The impact of the surface-modified beads on circulating bacteria (Staphylococcus aureus) has been tested in a simulated invitro circulation. In vitro experiments were carried out with 800 mL of blood enriched with S. aureus species. Blood was circulated in the vancomycin-functionalized and non-functionalized mini-module cartridges in hemoadsorption setup (300 mL each) and the bactericidal effect was assessed. Also, 200 mL of blood was used as a control. A significant increase in the time to positivity of blood cultures was observed after 60 min and also after 120 min of therapy with the mini-module functionalized with vancomycin as opposed to the non-functionalized cartridge. These results suggest a possible way of treating sepsis by using drug- or antibiotic-functionalized cartridges without worrying about pharmacological toxicity. The prolongation of the time to bacterial culture positivity to S. aureus after a passage through a column packed with beads functionalized with vancomycin represents a proof of concept.

Preliminary report on the benthic foraminifera in the seas surrounding the Tokara Islands, southwest Japan

Preliminary report on the benthic foraminifera in the seas surrounding the Tokara Islands, southwest Japan

Preliminary Report of the First Season of the “Land of the Storm God Survey” in Şehitkamil, Gaziantep, Türkiye

The results of the first campaign of the “Land of the Storm God Survey” in the Şehitkamil district of Gaziantep province in Southeastern Türkiye are—according to the two foci of the survey—twofold: First, an off-site survey on the slopes of Dülük Baba Tepesi, the home of a storm god temple built during the Middle Iron Age, was conducted. Here, an expansion of the Roman “priest necropolis,” a second necropolis on the Southern slope, as well as economical installations of Late Antiquity have been documented. The second focus is an on-site survey, where the investigation of six archaeological sites in the vicinity revealed longer settlement phases than previously assumed.

Epidemiological data of suicidal behaviour – how to inform and not to disinform?

Introduction and objective: Suicide is a significant global public health concern. Media reporting greatly influences suicide prevention efforts, with the Internet and social media playing a major role. Inappropriate reporting can undermine prevention, while responsible reporting can have a preventive effect. The World Health Organization and the International Association for Suicide Prevention have issued a set of guidelines for journalists, which are also available in the Polish language. This article is a preliminary report on suicide behaviour epidemiology reporting in the Polish media. Materials and methods: The study used data from the National Police Headquarters to analyse suicide attempts and deaths in Poland between 2017 and 2022. Population size data was obtained from the Statistics Poland website. News analysis was conducted using the BuzzSumo Enterprise Application to assess social media shares and engagements for the top 100 popular web pages with the keyword “suicide” in the Polish language news between 2017 and 2022. Results: The study found that media articles often omitted standardised indicators when reporting suicide statistics. The media focus on growing suicide mortality among children and adolescents was evident, while a similar trend among older adults received only limited attention. Additionally, some articles failed to distinguish between suicide attempts and deaths, used sensational language in the headlines, and did not consider changes in reporting methodologies, leading to potential misinterpretations of suicide-related data. Conclusions: Responsible reporting is crucial to prevent negative effects on public health. Understanding the association between suicide and misinformation can lead to targeted interventions and strategies to safeguard well-being.

Breastfeeding vs. Formula Feeding and Maternal Sexuality among Polish Women: A Preliminary Report.

Although postpartum sexual problems are common, there is a poor understanding of the underlying influencing factors and the impact of the infant feeding method on the mother's sexual life. A cross-sectional control study was conducted with a group of 253 women during their postpartum period. This study aimed to investigate the effects of different infant feeding methods on female sexual life after childbirth. The study followed the STROBE guidelines for cross-sectional control analysis. The study design included a questionnaire characterizing sociodemographic, obstetric and breastfeeding variables and the PL-FSFI (Female Sexual Function Index). The authors collected the data in compliance with the CAWI (Computer-Assisted Web Interview) research methodology-an interview conducted via an Internet channel. Each respondent received and completed the survey provided to them via the same online link. This study included women in the postpartum period: 170 breastfeeding women (study group) and 83 formula-feeding women (control group). There were statistically significant difference between the groups that practiced different types of breastfeeding. Out of all the PL-FSFI-assessing domains, the highest average score for the whole group correlated with satisfaction and the lowest score correlated with lubrication use. Our findings indicate that women practicing only breastfeeding are more likely to develop sexual problems. In order to maintain sexual health and promote long-term breastfeeding, extensive and professional counseling is needed for couples about postpartum sexuality and the factors that affect it, such as breastfeeding.

Thermographic profile of the face before treatment with autologous preparation – a preliminary report

The paper presents a thermographic image of the face of a 30-year-old patient before an autologous procedure using her own blood (CGF-Harmony) in the upper and middle parts of the face. The thermographic method is non-invasive, safe and non-contact. The possibility of using thermography in aesthetic medicine is important because it brings certain values, but one should be aware of the existence of certain limitations in thermography tests, resulting from many factors such as diet, use of various cosmetics, other environmental conditions and others.

How Does Aphasia Affect Quality of Life? Preliminary Reports.

Aphasia leads to disability, which, in turn, limits and can result in a complete breakdown of roles and social bonds. Thus, the aim of this study was to assess the impact of aphasia disorders on the quality of life of patients after an ischemic stroke. A prospective study among 116 patients with an ischemic stroke (the study group: 68 participants, 38.25% female, included patients with aphasia after a stroke; the control group: 48 patients, 37.5% female, without aphasia) was conducted at the Neurological Department of the Provincial Specialist Hospital in Włocławek. The patients were assessed twice: the first assessment was conducted during hospitalization using the Aphasia Dynamics Assessment Scale and the Aphasia Test Method of Jadwiga Szumska, and the second assessment of the quality of life after six months was conducted using the WHOQOL-BREF questionnaire. The patients from the control group rated their overall quality of life more highly than the patients from the study group. Statistically significant differences were observed in the physical domain, the psychological domain, and the environmental domain. The analysis of sociodemographic factors indicated a negative impact on the quality of life of the following variables: female gender, 55-64 years of age, vocational education, and place of residence-rural area. The degree and type of aphasia influenced the overall quality of life. Studies with larger samples are necessary.

Preliminary Report on PEG-Interferon-Induced Depressive- and Anxiety-like Responses in Mice

Preliminary Report on PEG-Interferon-Induced Depressive- and Anxiety-like Responses in Mice

Assessment of Galvanic Corrosion in Molten Salts

Molten salts are an excellent choice for thermal energy storage materials in concentrated solar power (CSP) plants, yet some salts can cause corrosion of containment alloys that damage plants and increase maintenance costs. Corrosion rates have been characterized for many salt/alloy combinations. However, corrosion rates at junctions of dissimilar alloys in molten salts are relatively poorly characterized. At such junctions, which are common in CSP plants, it is possible that galvanic interactions or other mechanisms could increase corrosion above the industry standard of 20 µm/year. Preliminary reports measured corrosion at dissimilar alloy junctions with a variety of methods, but the results are not uniform. Additionally, some reports have shown that corrosion rates are higher for single alloys than for the same alloys when paired in a galvanic couple, suggesting complex corrosion mechanisms. Here we present a discussion on measuring galvanic corrosion in molten salts that accounts for differences in results between methods and explores the possibility of other mechanisms of corrosion in the system.

Bone-Anchored Maxillary Protraction for Adolescents with Cleft Palate and Class III Malocclusion: A Case Series

To describe the long-term treatment course of bone-anchored maxillary protraction (BAMP) and evaluate orthognathic surgical indications after BAMP Retrospective case series Craniofacial/Cleft Palate Program at the Orthopaedic Institute for Children in Los Angeles, CA Twelve male patients with cleft palate (CP), unilateral cleft lip and palate (UCLP), or bilateral cleft lip and palate (BCLP) and Class III malocclusion treated with BAMP (mean age: 11.4 ± 2.6 years) were included. BAMP treatment was performed by placement of bone-anchored maxillary and mandibular plates connected with intraoral Class III dental elastics or maxillary plates connected to a facemask. We retrospectively assessed BAMP treatment variables, including age at surgery, revision surgeries, and treatment duration. The primary goal was correction to class I occlusion. Twelve patients underwent BAMP treatment for an average of 4.4 ± 2.4 years. Two patients were corrected to class I occlusion at the time of this report. Le Fort I advancement was no longer required in two patients (16.7%), it was required for nine patients (75.0%) and was completed for one patient following BAMP treatment (8.3%). This preliminary report demonstrated that BAMP treatment may be associated with a minimal reduction in the requirement for Le Fort I advancement at skeletal maturity. Future studies with larger sample sizes are necessary to confirm this association.

The Archaeological Site of Tumshukayko (Peru): A Preliminary Report

AbstractIn 2021, an Italian-Peruvian archaeological team began a research project in the Ancash Sierra to investigate the origins of early monumental architecture in the northern-central Andes. The large complex of Tumshukayko—located in the northern part of the town of Caraz in Ancash, Peru—was immediately found to be the most suitable site for this project. This report presents an initial description of the current state of the remains, topographical data, and test pit results. Preliminary data suggest that Tumshukayko is a multicomponent site comprising at least two mounds that were built during the Initial Formative period (2500–1500 BC).

Percutaneous uniportal full-endoscopic surgery for treating symptomatic lumbar facet joint cysts under local anesthesia combined with monitored anesthesia care: a preliminary report of eight cases with at least 1 year follow-up.

Lumbar facet joint cysts (FJCs) are a relatively rare clinical pathology that can result in radiculopathy or neurogenic claudication. Various treatments such as percutaneous aspiration and surgery have been reported to have good clinical outcomes. However, few clinical studies have aimed to treat symptomatic lumbar FJCs by using uniportal full-endoscopic (UFE) surgery. This study aimed to investigate the preliminary clinical outcomes of UFE surgery for the treatment of lumbar FJCs under local anesthesia combined with monitored anesthesia care (MAC). Eight patients (five males and three females) with symptomatic lumbar FJCs who underwent UFE surgery under local and MAC anesthesia were enrolled in this study between January 2018 and April 2022. The clinical characteristics, radiological features, operative information, visual analog scale (VAS) score, Oswestry disability index (ODI), and overall outcome rating based on the modified MacNab criteria were retrospectively analyzed. Of the eight patients, four underwent a transforaminal approach and four underwent an interlaminar approach. Postoperatively, the mean VAS score for leg pain decreased from 6.1 before surgery to 0.6 after surgery, and the ODI decreased from 74.5% to 14.7%. All patients were followed up for more than 1 year, and the good-to-excellent rate based on the modified MacNab criteria remained 100% at the last follow-up. No complications occurred during the follow-up period. Lumbar FJCs can cause severe radiating leg pain and/or neurogenic claudication due to the dural sac compression and nerve roots. As an alternative treatment, UFE decompression under local and MAC anesthesia may provide effective clinical outcomes for symptomatic lumbar FJCs.

Characteristics of clinical manifestations of allergy in correlation with cow’s milk-sIgE components in children – preliminary reports

Background: Cow’s milk, which is one of the first foods in human life, is also one of the most common causes of food allergy in infants and young children, as well as anaphylaxis in the youngest population. Thanks to component diagnostics, it is possible to accurately determine the concentrations of antibodies specific to individual milk proteins. The aim of the study was to determine the relationship between the cow’s milk component-specific IgE and the type of clinical manifestation of allergy. Materials and methods: Eighteen children with documented IgE-mediated allergy to cow’s milk proteins were enrolled in the study. Blood samples (2 mL) were collected from each patient for component diagnostics using the ALEX test. Results: The antibodies that were most frequently found among the children with cow’s milk allergy were antibodies against casein (Bos d 8). There were no statistically significant relationships between the clinical symptoms and the levels of individual components. A statistically significant relationship was observed between the concentration of α-lactalbumin (Bos d 4) and the duration of clinical symptoms of allergy to cow’s milk protein. Conclusions: The results of our study indicate that the most common component is casein (Bos d 8). The relationship between the sensitisation to other components and clinical symptoms requires further research, which is currently being conducted.

Harnessing Nature’s Green Potential: Nanotechnology Driven Fabrication of Plant-Derived Nanoparticles

Millions of tons of metallic nanoparticles (MNPs) are synthesized each year and used in various fields like nano-enabled devices, personal care, medicine, food, and agriculture. The reaction chemicals and processes employed in the industrial synthesis of MNPs are well acknowledged to be hazardous to the environment.Green synthesis has been recommended as a means of minimizing the usage of harmful substances and adverse chemical modification in the synthesis of MNPs. Extracts of organic chemicals, microorganisms, plants and plant-derived materials have all been employed as reducing agents in green synthesis.One of the most efficient, easy, cost-effective, and environmentally acceptable techniques for reducing the usage of toxic chemicals is to employ plant extracts in the synthesis of MNPs. Several eco-friendly procedures for the fast production of MNPs have been reported by utilizing aqueous extracts of plant components including the leaf, bark, flower, peel, shoot, tuber, resin, roots etc.Every year, new scientific publications are released, with each one highlighting the advantages of the green methodover classic synthesis. However, over two decades after the preliminary reports about the new technique exploded, commercial production of green-synthesized nanoparticle (NPs) does not appear to have found a means to scale up. This review covers green MNPs synthesis from various plant extracts and their potential applications as antimicrobial agents covering the literaturesince 2015. While highlighting the use of MNPs in a variety of fields and the potential impact of phytochemicals associated in MNPs production.

Preliminary results of the effect of music therapy treatment on anxiety, sadness, physical discomfort, mood, and quality of life in hospitalized onco-haematological patients

BackgroundPhysical and psychological distress may occur in patients facing an onco-haematological diagnosis and undergoing complex therapies such as intensive chemotherapy, stem cell transplantation, and immunotherapy. Studies have shown the need for incorporating different therapeutic modalities to respond to patients’ physical and psychosocial needs.AimsThe purpose of this study was to evaluate the effectiveness of music therapy treatment on mood, anxiety, depression, and physical discomfort in hospitalized onco-haematological patients.MethodsForty patients were included in this music therapy study from November 2021 to May 2023. Treatment consisted of individual weekly music therapy sessions. Participants completed the following evaluation instruments before and after the intervention: the Hospital Anxiety and Depression Scale (HADS), Profile of Mood States—Short Form A-Version (POMS-A), and European Organization for Research and Treatment of Cancer-Quality of Life Core Questionnaire-30 (EORTC QLQ-C30). A three-item numerical rating scale (NRS) for anxiety, sadness, and physical discomfort was administered at the beginning and end of each session (pre-/postsession).ResultsDifferences (p < 0.05) were shown in NRS scores for anxiety, sadness, and physical discomfort before and after the music therapy sessions. Quality of life (QoL) was affected in almost all items, and patients could be anxious at a nonclinical level, but they were clinically depressed. EORTC QLQ-C30 scores for insomnia and pain related to the hospitalization process got worse after discharge.ConclusionsThe interim results of our study showed that music therapy sessions can positively change emotional distress and improve the mood of haematological patients after every session. Despite the difficulties and limitations of this study, this preliminary report contributes to a greater understanding of the potential benefits of music therapy in hospitalized onco-haematological patients.

Association of Gut Microbiome with Diabetes Mellitus and Alzheimer’s Disease in a Puerto Rican Adult Population: A Preliminary Report

AbstractBackgroundAlzheimer’s disease (AD) is the most common cause of dementia, consisting in a highly debilitating disorder, progressing from slight memory impairments to a complete loss of mental function, resulting in significant disability and death. In Puerto Rico, AD is the fourth leading cause of death. Caribbean Hispanics, including Puerto Ricans living on the island have shown a more severe AD symptomatology and disease mortality than any other ethnic group. This disparity may be due to health, diet, lifestyle, socioeconomic risk factors and more prevalent chronic health conditions such as diabetes in Hispanic people. Diabetes Mellitus is nowadays considered a risk factor for AD. Evidence suggests that the gut microbiome plays a role in the pathophysiology of AD through neuroinflammation and amyloid deposition leading to cognitive impairment. Main objective: Study the microbiome composition and diversity of Puerto Ricans with AD compared to cognitive‐intact controls in association with Diabetes Mellitus.MethodFifty‐three participants (n = 53), 28 with AD and 25 controls were evaluated clinically and cognitively with the Montreal Cognitive Assessment (MoCA) to associate the gut microbiome with cognitive impairment. Stool was collected for genomic DNA extractions and microbiome characterization. NextGen Illumina MiSeq was used to sequence 16S rRNA genes (V4 region) and analyzed with standard pipelines.ResultNo statistically significant differences in bacterial diversity and richness between AD vs. controls. We found slight differences in composition, including an abundance of Euryachaeota in AD, while controls had higher levels of Bacteroidetes. Compared to cognitively intact, a decrease in gut microbiome diversity was seen among participants with cognitive decline (p = 0.02). Roseburia (butyrate producing bacteria) seems to decrease with cognitive impairment severity. Diabetics have significantly reduced Anaerostipes and Ruminococcus also butyrate producing bacteria. AD participants with/without Diabetes have predominance of Euryarchaeota. Controls with Diabetes have more Proteobacteria and Bacteroidetes compared to cognitively impaired.ConclusionBoth Diabetes and neurocognitive decline appear to reduce butyrate‐producing bacterias, which may be related to a decrease in the homeostasis of the gut‐brain axis and lead to microbiome dysbiosis in the setting of disease. A better understanding of the gut microbiome will be an invaluable approach for development of modulation‐based therapeutic interventions.

Investors' Reaction to Financial Reporting – Empirical Studies on Price Volatility on the Bucharest Stock Exchange

Abstract In this study, the impact of financial reporting upon investment decision is assessed through investors' behavior and measured by the stock price variation. This research analyzes preliminary, semestrial, and quarterly financial reports from 24 BSE listed companies, namely companies within the BET XT index (14) and companies within the BET AeRO index (10), over the reporting periods between 2018 and 2022. The main finding shows that investors, instead of being influenced by the market general trend, reacted rationally in 47% of the cases as they assigned the highest importance to the fundamentals from the preliminary reports. Based on the results obtained from the two indicators introduced in the research, we concluded that between financial reporting and market sentiment, the factor with the highest level of influence on price variation was financial reporting.

Associations between aerobic fitness and subsequent memory performance in non‐demented Presenilin‐1 E280A mutation carriers: A preliminary report from the Colombia‐Boston longitudinal biomarker study

AbstractBackgroundGreater aerobic fitness, objectively measured by VO2‐max, is considered a critical component of overall health and a strong predictor of cognitive functioning. It has been associated with less neurodegeneration in Alzheimer’s disease (AD) and greater functional brain connectivity and plasticity in healthy older adults. Yet, less is known about how it relates to AD progression in people at increased risk for dementia. In this study, we examined whether VO2‐max predicted memory decline in non‐demented mutation carriers and non‐carriers from a Colombian kindred with autosomal dominant AD (ADAD), and hypothesized that those with greater VO2‐max levels would exhibit slower cognitive decline.Methods12 Presenilin‐1 E280A mutation carriers (ages: μ = 39.61 years, SD:4.18) and 14 non‐carriers (ages: μ = 37.11 years, SD:6.59) underwent a standard graded maximal exercise test performed on a treadmill to assess their VO2‐max, which is the maximal rate of oxygen consumption during exercise, measured in milliliters of oxygen per minute per kilogram body mass. Participants also completed the CERAD word list learning and delayed recall, a measure of episodic memory, at baseline and again 18‐24 months later. Group differences were tested using the Mann‐Whitney U test. Linear mixed models were used to examine associations among baseline VO2 max and changes in CERAD word list test scores.ResultsVO2‐max levels did not differ between groups (p = .16). Compared to mutation non‐carriers, mutation carriers performed worse in word list learning (p = .008) and recall (p&lt;.001) at baseline. VO2‐max levels were not associated with baseline word list learning (non‐carriers: p = .93; carriers: p = .76) or recall scores (non‐carriers: p = .82; carriers: p = .63). Baseline VO2‐max levels did not predict change in word list learning (non‐carriers: p = .47; carriers: p = .85) or recall scores (non‐carriers: p = .70; carriers: p = .87).ConclusionPreliminary findings suggest that aerobic fitness, which can be increased with exercise and is associated with greater health, does not relate to memory decline in preclinical ADAD. This is an ongoing longitudinal study, and we will continue to collect more physical activity data in this kindred to characterize these associations better. More research with larger samples is needed to elucidate whether physical activity could help delay AD progression regardless of aerobic fitness levels.