Significant Effect Of Age Research Articles

Structural indices of brain aging in methamphetamine use disorder

BackgroundMethamphetamine use is surging globally. It has been linked to premature stroke, Parkinsonism, and dementia, suggesting that it may accelerate brain aging. MethodsWe performed a retrospective study to determine if structural indices of brain aging were more prevalent prior to old age (26 – 54 years) in individuals with Methamphetamine Use Disorder (MUD), who were in early abstinence (M ± SD = 22.1 ± 25.6 days) than in healthy control (HC) participants. We compared T1-weighted MRI brain scans in age- and sex-matched groups (n = 89/group) on three structural features of brain aging: the brain volume/cerebrospinal fluid (BV/CSF) index, volume of white matter hypointensities/lesions, and choroid plexus volume. ResultsThe MUD group had a lower mean BV/CSF index and larger volumes of white matter hypointensities and choroid plexus (p-values < 0.01). Regression analyses showed significant age-by-group effects, indicating different age trajectories of the BV/CSF index and choroid plexus volume, consistent with abnormal global brain atrophy and choroid plexus pathology in the MUD group. Significant age and group main effects reflected a larger volume of white matter hypointensities for older participants across groups and for the MUD group irrespective of age. None of the three measures of brain aging correlated significantly with recent use or duration of recent abstinence from methamphetamine. ConclusionsPremature brain pathology, which may reflect cerebrovascular damage and dysfunction of the choroid plexus, occurs in people with MUD. Such pathology may affect cognition and thereby efficacy of behavioral treatments for MUD.

Higher insoluble fiber intake is associated with a lower risk of prostate cancer: results from the PLCO cohort

Studies regarding the relationship between fiber intake and prostate cancer (PCa) have conflicting results. Therefore, this study examined the relationship between fiber intake and the risk of PCa by using data from Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. A total of 54,336 participants in the United States, consisting of 6,414 patients with PCa, were included in this study. Multivariate Cox regression models were applied to estimate adjusted hazard ratios (aHRs) and corresponding 95% confidence intervals (CIs). Compared with individuals in the lowest quartile, individuals in the highest quartile of insoluble fiber intake had a significantly lower risk of PCa (aHR, 0.87; 95% CI, 0.78–0.98). By contrast, no significant associations were detected between total fiber intake (aHR, 0.90; 95% CI, 0.80–1.01) or soluble fiber intake (aHR, 0.90; 95% CI, 0.80–1.02). Subgroup analyses showed that insoluble fiber was related to a decreased risk of PCa in subjects with the following characteristics: age > 65 years, nonsmoking or former smokers, education level ≤ high school, non-Hispanic white ethnicity, or without a family history of PCa. In addition, significant combined effects of insoluble fiber intake, age and family history of PCa on the risk of PCa were observed, but no combined effects of smoking status and insoluble fiber intake were observed. In addition, total fiber, insoluble fiber, and soluble fiber intake had no influence on the mortality of PCa patients. These results show that all 3 measures of fiber suggest a protective association, but insoluble fiber may have a stronger association with the risk of PCa. Future studies are warranted to further investigate these relationships.

An investigation of endometrial vascularity in normally menstruating women and those in other physiological states using 3D ultrasound imaging.

This study aimed to determine the normal vasculature indices of the endometrium and to correlate them with those in various physiological states. Women undergoing ultrasound at the Feto-Maternal Center, Qatar in 2020-2021 as part of their gynecologic evaluation were enrolled into the study. They were divided into those with normal menses and no additional pathology, those following spontaneous miscarriage, postpartum and menopausal. Three-dimensional (3D) evaluation of the endometrial vasculature was done and the parameters quantified included vascularization index (VI), flow index (FI), vascularization flow index (VFI), endometrial thickness, endometrial volume and uterine volume. JASP, an open-source statistical analysis software, was used for analysis and an independent t-test to compare the vascularity indices. A multivariate regression analysis was also done to look at the factors affecting the endometrial vascular indices within the luteal phase. A total of 461 women were studied: 122 in the follicular phase, 199 in the luteal phase, 90 after a spontaneous miscarriage, 29 postpartum, and 16 menopausal. The vascularity indices were highest after miscarriage and lowest postnatally. There were no significant effects of age, gravida, para, or abortions on VI and VFI. However, there was a significant positive effect of age on FI (P = 0.019) There was a significant increase in endometrial volume and thickness in the luteal phase as compared to follicular phase (P < 0.01), but there was no difference in the vascularity indices. The uterine and endometrial volume in the postnatal group were nearly double that of the luteal group (P value <0.01 and 0.014, respectively). There was a significant decrease in flow index in the postnatal group compared to the luteal group (P < 0.01), suggesting low flow intensity in the postnatal group. Endometrial vascular indices measured using 3D Doppler can be used to determine normal vascular indices and vary with physiological states such as after miscarriages, postnatally and in the menopausal states.

The significance and limited influence of cerebrovascular reactivity on age and sex effects in task- and resting-state brain activity.

Functional MRI measures the blood-oxygen-level dependent signals, which provide an indirect measure of neural activity mediated by neurovascular responses. Cerebrovascular reactivity affects both task-induced and resting-state blood-oxygen-level dependent activity and may confound inter-individual effects, such as those related to aging and biological sex. We examined a large dataset containing breath-holding, checkerboard, and resting-state tasks. We used the breath-holding task to measure cerebrovascular reactivity, used the checkerboard task to obtain task-based activations, and quantified resting-state activity with amplitude of low-frequency fluctuations and regional homogeneity. We hypothesized that cerebrovascular reactivity would be correlated with blood-oxygen-level dependent measures and that accounting for these correlations would result in better estimates of age and sex effects. We found that cerebrovascular reactivity was correlated with checkerboard task activations in the visual cortex and with amplitude of low-frequency fluctuations and regional homogeneity in widespread fronto-parietal regions, as well as regions with large vessels. We also found significant age and sex effects in cerebrovascular reactivity, some of which overlapped with those observed in amplitude of low-frequency fluctuations and regional homogeneity. However, correcting for the effects of cerebrovascular reactivity had very limited influence on the estimates of age and sex. Our results highlight the limitations of accounting for cerebrovascular reactivity with the current breath-holding task.

Variability in Receptive Language Development Following Bilateral Cochlear Implantation.

The primary aim was to investigate the variability in language development in children aged 5-7.5 years after bilateral cochlear implantation (CI) up to the age of 2 years, and any impact of the age at implantation and additional noncognitive or anatomical disorders at implantation. Data of 84 congenitally deaf children that had received simultaneous bilateral CI at the age of ≤ 24 months were included in this retrospective study. The results of language comprehension acquisition were evaluated using a standardized German language acquisition test for normal hearing preschoolers and first graders. Data on speech perception of monosyllables and sentences in quiet and noise were added. In a monosyllabic test, the children achieved a median performance of 75.0 ± 12.88%. In the sentence test in quiet, the median performance was 89 ± 12.69%, but dropped to 54 ± 18.92% in noise. A simple analysis showed a significant main effect of age at implantation on monosyllabic word comprehension (p < .001), but no significant effect of comorbidities that lacked cognitive effects (p = .24). Language acquisition values correspond to the normal range of children with normal hearing. Approximately 25% of the variability in the language acquisition tests is due to the outcome of the monosyllabic speech perception test. Congenitally deaf children who were fitted bilaterally in the 1st year of life can develop age-appropriate language skills by the time they start school. The high variability in the data is partly due to the age of implantation, but additional factors such as cognitive factors (e.g., working memory) are likely to influence the variability.

Exploratory analysis of the effectiveness of virtual reality in cardiovascular rehabilitation

Virtual reality therapy has been shown to be effective in coping with psychological disorders accompanied by cardiovascular disease. Age appears to be a factor that can affect the effectiveness of psychological therapy in a virtual environment. Therefore, the aim of the study was to explore whether there are age-related differences in the effectiveness of reducing levels of depression and anxiety during a virtual reality psychological intervention implemented for rehabilitation. The study included 25 younger (< 65 years) and 25 older (65 +) patients with cardiovascular disease who participated in virtual reality therapy to cope with anxiety and depression. The Hospital Anxiety and Depression Scale was used to assess anxiety and depressive disorders before and after intervention. Significant reductions in anxiety and depression scores after intervention were observed in both age-matched groups, and no significant differences were found between the younger and older participants. Further evaluation of patient age as a predictor of the effectiveness of psychological intervention in virtual reality did not show a significant effect of age on effectiveness in reducing anxiety and depressive disorders. The results obtained suggest that older patients benefit similarly to younger patients from psychological intervention in a virtual environment. Furthermore, age does not appear to be considered a predictor of effectiveness in reducing the level of anxiety and depression in patients with cardiovascular disease using virtual reality therapy.

Serum Cholesterol Level Changes during Gonadotropin-Releasing Hormone-Agonist Therapy in Premenopausal Female Patients with Breast Cancer.

To investigate the changes in cholesterol levels during medical ovarian suppression. We reviewed the medical records and blood test results of 187 female patients with breast cancer who underwent gonadotropin-releasing hormone (GnRH)-agonist therapy for > 24 weeks at our hospital between 1 January 2018 and 31 December 2020. The study excluded patients in this cohort who had previously been diagnosed with dyslipidemia, diabetes, or had recently received lipid-lowering agents, resulting in a final sample size of 152 participants. The age at diagnosis and preoperative body mass index (BMI) were included as baseline demographics. A generalized additive mixed model was applied to analyze the relationship between the duration of GnRH-agonist treatment and changes in cholesterol levels. The study participants had a mean age of 42.5 ± 5.2 years and a mean preoperative BMI of 23.0 ± 3.6 kg/m²; the mean GnRH-agonist therapy duration was 19.3 months (range: 5.6-37.7 months); and the total cholesterol level before GnRH-agonist treatment was 171 mg/dL that was significantly higher at 181 mg/dL (P = 0.03) during the most recent measurement. The total cholesterol level was unaffected by the GnRH-agonist therapy until 19.3 months after which it significantly increased by 1.28 mg/dL per month (P = 0.011). There was no significant effect of age, preoperative BMI, or the glomerular filtration rate on the total cholesterol levels. Long-term GnRH agonist therapy for > 19 months can cause a significant increase in the serum cholesterol levels. To prevent complications, patients receiving the treatment should be informed and monitored for the possible progression of dyslipidemia.

Analysis of musculoskeletal pains and productivity impacts among hispanic construction workers

This study investigated the top three musculoskeletal pains (MSP) among Hispanic construction workers in Texas and the relationship between sleep hours, age, and MSPs on worker productivity. The study recruited 228 participants from 28 small construction companies and surveyed them on their occupation, age, sleep hours, MSP, and the impact of pain on productivity. The results indicated that Foot pain was the most common among these workers, followed by Back pain and others. Additionally, the study found that the Foot was the most common body part reported with MSP among roofers, drywall installers, laborers, and helpers. The study conducted a three-factor ANOVA test to analyze if there were any significant differences in productivity based on age, number of MSPs, and sleep hours. The study found that MSPs and sleep hours significantly impacted productivity. However, there was no significant effect of age. The results also showed that the number of MSPs significantly impacted productivity, with an increase in MSPs leading to a more severe impact on productivity. Additionally, those who slept less than 6 h per day had a more severe impact on productivity than those who slept more. The study suggests that targeted interventions to improve musculoskeletal health and productivity in this population are needed and highlights the importance of considering Hispanic construction workers' specific needs when implementing safety measures and addressing pain management in the workplace.

Perception of voice cues in school-age children with hearing aids.

The just-noticeable differences (JNDs) of the voice cues of voice pitch (F0) and vocal-tract length (VTL) were measured in school-aged children with bilateral hearing aids and children and adults with normal hearing. The JNDs were larger for hearing-aided than normal-hearing children up to the age of 12 for F0 and into adulthood for all ages for VTL. Age was a significant factor for both groups for F0 JNDs, but only for the hearing-aided group for VTL JNDs. Age of maturation was later for F0 than VTL. Individual JNDs of the two groups largely overlapped for F0, but little for VTL. Hearing thresholds (unaided or aided, 500-400 Hz, overlapping with mid-range speech frequencies) did not correlate with the JNDs. However, extended low-frequency hearing thresholds (unaided, 125-250 Hz, overlapping with voice F0 ranges) correlated with the F0 JNDs. Hence, age and hearing status differentially interact with F0 and VTL perception, and VTL perception seems challenging for hearing-aided children. On the other hand, even children with profound hearing loss could do the task, indicating a hearing aid benefit for voice perception. Given the significant age effect and that for F0 the hearing-aided children seem to be catching up with age-typical development, voice cue perception may continue developing in hearing-aided children.

Assessment of motor skills in 5-6 year old Italian children using the MABC-2: a preliminary study

The Movement Assessment Battery for Children - Second Edition (MABC-2) is a standardized test used to assess movement skills in children aged between 3-16 years old and to diagnose developmental coordination disorders (DCDs). Monitoring movement skills in children’s is crucial to ensuring their proper physical development, as movement difficulties affect other areas of learning. In particular, it was interesting to investigate the role of gender and age in relation to different movement skills, as their development is influenced by genetic potential, in order which variables can help teachers to predict movement difficulties. The aim of the present study was to quantify the children's movement performance and to analyze the influence of gender, age and the gender x age interaction on movement performance. Methods: The sample consisted of 102 children aged between 5-6 years old from kindergartens. The MABC-2 was used to assess the children's movement performance, which comprised three sub-sections: manual skills, ball skills and balance skills. MANOVA was performed to assess the impact of gender, age and gender x age on performance. Chi Square was used to test differences in movement difficulties among gender. Results: The results showed a significant impact of both gender and age on performance individually, with a significant interaction effect of gender and age on performance. Conclusions: 12 children had several movement difficulties, while only 9 were at risk of DCDs, requiring ecological intervention.

Immediate and Long-Term Pull-Out Bond Strength of 3D-Printed Provisional Crowns.

Background: Over the past decade, 3D printing technology has revolutionized various fields, including dentistry. Provisional restorations play a crucial role in prosthetic rehabilitation, necessitating the evaluation of their bond strength with different provisional cement agents. Aims: This study is aimed at assessing the immediate and long-term bond strength of 3D-printed dental crowns using three provisional cement agents. Materials and Methods: Provisional crowns (N = 36) were manufactured using 3D modeling software and cemented in dentin analogues (G10 Nema resin). After the crowns' fabrication, they were randomly divided into three groups (n = 12) for cementation with Relyx Temp 3M ESPE, Provicol-VOCO, and Meron-VOCO. Tensile strength tests were conducted using a universal testing machine, with half of the specimens subjected to 2000 thermal cycles before testing. Finite element analysis was employed to assess tensile stress distribution. Results: Statistical analysis (two-way ANOVA and Tukey's test at a 95% confidence level) revealed significant effects of cement type (p = 0.006) and thermal aging (p = 0.001) on bond strength. Glass ionomer cement exhibited the highest immediate resistance, while all types of cement were adversely affected by thermal aging, resulting in decreased bond strength. Conclusion: Thermal aging significantly alters the properties of 3D printing resin and affects the bond strength of provisional cement with 3D-printed crowns. Despite the adverse effects of thermal aging, glass ionomer cement demonstrated the highest immediate resistance. Clinicians should carefully consider these findings when selecting provisional cements for 3D-printed crowns.

A meta-analysis on the relation between handwriting and visual-motor integration

Visual-motor integration is typically viewed as an important variable, subskill, or integral component of children's skilled handwriting; however, the handwriting-VMI correlation varies across studies, and its function remains elusive. In this context, this study aimed to quantify this relation and examine the moderation effects of handwriting dimensions, script types, age, and sample status. A moderate (r = 0.29, 95 % CI [0.23, 0.34]) handwriting-VMI relationship was identified based on 29 studies with 47 unique samples. Script types, age, and sample status were found to be significant moderators, whereas ‘handwriting dimensions’ was non-significant. Despite the nonsignificance of handwriting dimensions, handwriting legibility, pressure, and speed had a significant positive, negative, and non-significant correlation with VMI, respectively; handwriting had a significantly higher correlation with VMI for logographic scripts than alphabetic scripts, for children younger than six than their older counterparts, and for mixed-group students than typically-developing ones. Implications, limitations, and future directions are discussed. Educational relevance and implicationsUsing the meta-analysis method, this study identified a moderate relationship (r = 0.29, 95 % CI [0.23, 0.34]) between handwriting and VMI and clarified the significant moderation effects of script types, age, and sample status. Theoretically, both the perceptual-motor and spatial cognitive skill(s) (components) are highlighted to permeate handwriting and VMI, which may act as the theoretical basis for educators and researchers in future empirical investigations to unpack further the handwriting-VMI relationship as well as children's handwriting problems. From a practical point of view, the results of this study suggest a specific pathway that may assist in the early identification of potential handwriting problems: the relationship between handwriting and VMI. The handwriting-VMI relationship varying across different sub-groups further highlights the importance of task and population characteristics in differentiating the specific relations behind them, helping clinicians determine which task and/or population could work/benefit most from further relevant assessment and treatment.

Analysis of Skin Color Variation using CIELAB Index: An Empirical Study from Delhi, India

Skin color is a conspicuous trait regulated by complex metabolic processes and its significant diversity among Indian populations is quite remarkable making it an ideal choice for dermatological investigation. To elucidate skin pigment variation with respect to age, we studied 714 healthy individuals (aged 20-70 years) using CIELAB system. Skin reflectance was measured from the volar surface of upper arm using DSM II ColorMeter (Cortex Technology, Hadsund, Denmark) among population of Delhi, India to provide CIELAB color space values, L* (light/dark), a* (red/green), and b* (yellow/blue) followed by statistical analysis to examine the correlation between age and gender on skin on constitutive skin pigmentation. The studied parameters were observed to vary widely {L* (Range: 24.98-51.62, M=38.66, SD=4.41), a* (Range: 4.61-17.16, M=10.18, SD=2.03), and b* (Range: 20.16-34.83, M=28.93, SD=2.30)} across all age groups. ANOVA results suggest a statistically significant effect of age on skin lightness {F(4,709)=124.1332, p&lt;0.001}, redness {F(4,709)=20.0594, p&lt;0.001} and yellowness {F(4,709)=95.1434, p&lt;0.001}. Positive correlation was observed between age and both hue (ho) {r(712)=0.9027, p&lt;0.001} and chroma (C) {r(712)=0.9224, p&lt;0.001}. Significant effects of gender were noticed on skin lightness among all age groups, along with skin redness below the age of 40 years (p&lt;0.001). Notable color differences (∆Ε∗ab) were witnessed among males and females across all age groups in the studied population. The age group 21-30 years was found to have the highest ∆Ε∗ab value (3.5987), followed by 51-60 years (2.98), 31-40 years (2.5579), 61-70 years (2.1837), and 41-50 years (1.6639). We would like to highlight that skin lightness, redness, and yellowness differs significantly with age. Females were observed to be lighter in color as compared to males across all age groups. The findings of the current study would provide better understanding of skin color variation among Indian population.

Gray matter asymmetry alterations in children and adolescents with comorbid autism spectrum disorder and attention-deficit/hyperactivity disorder.

Despite the high coexistence of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) (ASD + ADHD), the underlying neurobiologicalbasis of this disorder remains unclear. Altered brain structural asymmetries have been verified in ASD and ADHD, respectively, making brain asymmetry a candidate for characterizing this coexisting disorder. Here, we measured the gray matter (GM) volume asymmetry in ASD + ADHD versus ASD without ADHD (ASD-only), ADHD without ASD (ADHD-only), and typically developing controls (TDc). High-resolutionT1-weighted data from 48 ASD + ADHD, 63 ASD-only, 32 ADHD-only, and 211 matched TDc were included in our study. We also assessed brain-behavior relationships and the effects of age on GM asymmetry. We found that there were both shared and disorder-specific GM volume asymmetry alterations in ASD + ADHD, ASD-only, and ADHD-only compared with TDc. This finding demonstrates that ASD + ADHD is neither an endophenocopy nor an additive pathology of ASD and ADHD, but an entirely different neuroanatomical pathology. In addition, ASD + ADHD displayed altered GM volume asymmetries in the prefrontal regions responsible for executive function and theory of mind compared with ASD-only. We also found significant effects of age on GM asymmetry. The present study may provide structural insights into the neural basis of ASD + ADHD.

Aging pattern of the brainstem based on volumetric measurement and optimized surface shape analysis.

The brainstem, a small and crucial structure, is connected to the cerebrum, spinal cord, and cerebellum, playing a vital role in regulating autonomic functions, transmitting motor and sensory information, and modulating cognitive processes, emotions, and consciousness. While previous research has indicated that changes in brainstem anatomy can serve as a biomarker for aging and neurodegenerative diseases, the structural changes that occur in the brainstem during normal aging remain unclear. This study aimed to examine the age- and sex-related differences in the global and local structural measures of the brainstem in 187 healthy adults (ranging in age from 18 to 70years) using structural magnetic resonance imaging. The findings showed a significant negative age effect on the volume of the two major components of the brainstem: the medulla oblongata and midbrain. The shape analysis revealed that atrophy primarily occurs in specific structures, such as the pyramid, cerebral peduncle, superior and inferior colliculi. Surface area and shape analysis showed a trend of flattening in the aging brainstem. There were no significant differences between the sexes or sex-by-age interactions in brainstem structural measures. These findings provide a systematic description of age associations with brainstem structures in healthy adults and may provide a reference for future research on brain aging and neurodegenerative diseases.

Short-term effects of exposure to ambient PM2.5 and its components on hospital admissions for threatened and spontaneous abortions: A multicity case-crossover study in China

BackgroundThe adverse effects of short-term exposure to PM2.5 and its components on hospital admissions for threatened and spontaneous abortions (TSAB) are still controversial. MethodsData on daily hospitalizations for TSAB and PM2.5 and its components, including sulfate (SO42−), nitrate (NO3−), ammonium salt (NH4+), organic matter (OM), and black carbon (BC), were collected from January 2015 to December 2021 (total 2,557 days) in five cities in China. Case-crossover analyses were conducted to investigate the short-term associations between PM2.5 and its components and TSAB. Additionally, the modification effects by age (<35 and ≥35 years), season (cold and warm seasons), and the “Three-Year Action Plan to Win the Blue Sky Defense War” (before and after implementation) on the above associations were further conducted. ResultsFor each 10 μg/m3 (1 μg/m3 for BC) increase, the strongest relative risks (95% confidence intervals) of hospitalization for TSAB were 1.011 (1.001–1.021) for PM2.5 in lag02, 1.060 (1.003–1.120) for SO42− in lag02, 1.035 (1.000–1.070) for NO3− in lag02, 1.065 (1.009–1.124) for NH4+ in lag02, 1.047 (1.008–1.088) for OM in lag01 and 1.029 (1.005–1.054) for BC in lag02 (all P <0.05). Furthermore, significant modifying effects of age and the Action Plan were found. The effects of NO3− (lag2), NH4+ (lag2), and BC (lag2) were more pronounced in mothers aged ≥35 years and the effects of PM2.5 (lag4), NO3− (lag4), NH4+ (lag4), OM (lag4), and BC (lag4) was more pronounced in the period before the Action Plan was implemented (all P modification <0.05). ConclusionShort-term exposure to ambient PM2.5 and its components (SO42−, NO3−, NH4+, OM, and BC) was related to increased risks of hospitalization for TSAB. The effects were more pronounced in mothers aged ≥35 years and the period before the Action Plan.

Accident Probability Prediction and Analysis of Bus Drivers Based on Occupational Characteristics

A city bus carries a large number of passengers, and any traffic accidents can lead to severe casualties and property losses. Hence, predicting the likelihood of accidents among bus drivers is paramount. This paper considered occupational driving characteristics such as cumulative driving duration, station entry and exit features, and peak driving times, and categorical boosting (CatBoost) was used to construct an accident probability prediction model. Its effectiveness was confirmed by the daily management data of a Chongqing bus company in June. For data processing, Multiple Imputation by Chained Equations for Random Forests (MICEForest) was used for data filling. In terms of prediction, a comparative analysis of four boosted trees revealed that CatBoost exhibited superior performance. To analyze the critical factors affecting the probability of bus driver accidents, SHapley Additive exPlanations (SHAP) was applied to visualize and interpret the results. In addition to the significant effects of age, rainfall, and azimuthal change, etc., we innovatively discovered that the proportion of driving duration during peak duration, the dispersion when entering and exiting stations, the proportion of driving duration within a week, and the accumulated driving duration of the previous week also had varying degrees of impact on accident probability. Our research and findings provide a new idea of accident prediction for professional drivers and direct theoretical support for the accident risk management of bus drivers.

SUBJECTIVE COGNITIVE DECLINE MODERATES THE ASSOCIATION BETWEEN AGE AND MEMORY DECLINE IN MIDLIFE

Abstract Subjective cognitive decline (SCD) represents self-perceived worsening of memory and thinking abilities, in the absence of objective cognitive impairment, and serves as a prognostic marker of Alzheimer’s disease (AD). However, no study to date has investigated whether SCD moderates the relationship between aging and memory before older ages. We tested the hypothesis that SCD interacts with age to predict memory performance in midlife. A subset of 123 cognitively unimpaired, middle-aged adults (Mage=56.6±6.44 years; 87% females) from an ongoing clinical trial (NIH R01AG058919) were included for analyses. Multiple linear regression models tested the effects of age and SCD in predicting performance of mnemonic discrimination, auditory-verbal memory, visuospatial memory, paired associative memory, and verbal logical memory, while controlling relevant covariates (e.g., education, sex, and APOE ε4). Based on the optimal cutoff of the Everyday Cognition Scale, 28.2% of the sample were considered to have SCD and 71.8% perceived themselves to have normal cognition. After covariate adjustments, there were significant main and interaction effects of SCD and age on mnemonic discrimination performance on the Mnemonic Similarity Task (MST) but not on other memory outcomes. The negative relationship between age and mnemonic discrimination was evident in middle-aged adults who self-report cognitive concerns but not in those without such concerns. Since mnemonic discrimination is highly sensitive to hippocampal function, these findings support the utility of the MST to detect age-related hippocampal changes and ensuing memory declines in midlife as well as the importance of early interventions among middle-aged adults with SCD to prevent AD.

Mapping internal brainstem structures using T1 and T2 weighted 3T images.

Many neurodegenerative diseases affect the brainstem and often do so in an early stage. The overall goal of this project was (a) to develop a method to segment internal brainstem structures from T1 and T2 weighted sequences by taking advantage of the superior myelin contrast of the T1/T2 ratio image (RATIO) and (b) to test if this approach provides biological meaningful information by investigating the effects of aging on different brainstem gray matter structures. 675 T1 and T2 weighted images were obtained from the Human Connectome Project Aging. The intensities of the T1 and T2 images were re-scaled and RATIO images calculated. The brainstem was isolated and k-means clustering used to identify five intensity clusters. Non-linear diffeomorphic mapping was used to warp the five intensity clusters in subject space into a common space to generate probabilistic group averages/priors that were used to inform the final probabilistic segmentations at the single subject level. The five clusters corresponded to five brainstem tissue types (two gray matters, two mixed gray/white, and 1 csf/tissue partial volume). These cluster maps were used to calculate Jacobian determinant maps and the mean Jacobians of 48 brainstem gray matter structures extracted. Significant linear or quadratic age effects were found for all but five structures. These findings suggest that it is possible to obtain a biologically meaningful segmentation of internal brainstem structures from T1 and T2 weighted sequences using a fully automated segmentation procedure.

Association between adherence to posttreatment National Comprehensive Cancer Network (NCCN) surveillance guidelines and detection of recurrent uterine cancer

ObjectiveTo identify correlations between disease recurrence and adherence to NCCN posttreatment surveillance guidelines in patients who develop recurrent uterine cancer. MethodsRetrospective analysis identified patients (n = 60) with recurrent uterine cancer and at least one surveillance visit with a gynecologic oncologist between 2011 and 2020. Adherence to NCCN guidelines and details of recurrence were recorded. ResultsRecurrent uterine cancer was identified in 60 patients with an average time to recurrence (TTR) of 25 months. Of those, 39 (65%) were adherent to NCCN surveillance guidelines and 36 (60%) were symptomatic at the time of recurrence diagnosis. Asymptomatic recurrence was diagnosed by imaging in 11 (46%), physical exam in 7 (29%), and blood work in 6 (25%) patients. Patients who were adherent to NCCN guidelines were diagnosed with recurrence on average 11 months earlier (p = 0.0336). Adherence was an independent predictor of TTR for all patients regardless of symptoms. There was no significant effect of age, race, primary language, or stage of disease on adherence. ConclusionAdherence to NCCN posttreatment surveillance guidelines for uterine cancer is independently associated with an earlier diagnosis of recurrence.