Mitochondrial DNA Copy Number Is Associated With Treatment Response and Cognitive Function in Euthymic Bipolar Patients Receiving Valproate

BackgroundBipolar disorder (BD) is associated with cognitive impairment and mitochondrial dysfunction. However, the associations among mitochondrial DNA copy number (MCN), treatment response, and cognitive function remain elusive in BD patients.MethodsSixty euthymic BD patients receiving valproate (VPA) and 66 healthy controls from the community were recruited. The indices of metabolic syndrome (MetS) were measured. Quantitative polymerase chain reaction analysis of blood leukocytes was used to measure the MCN. Cognitive function was measured by calculating perseverative errors and completed categories on the Wisconsin Card Sorting Test (WCST). The VPA treatment response was measured using the Alda scale.ResultsBD patients had significantly higher MCN, triglyceride, and C-reactive protein (CRP) levels, waist circumference, and worse performance on the WCST than the controls. Regression models showed that BD itself and the VPA concentration exerted significant effects on increased MCN levels. Moreover, the receiver operating characteristic curve analysis showed that an MCN of 2.05 distinguished VPA responders from nonresponders, with an area under the curve of 0.705 and a sensitivity and specificity of 0.529 and 0.816, respectively. An MCN level ≥2.05 was associated with 5.39 higher odds of being a VPA responder (P = .006). BD patients who were stratified into the high-MCN group had a higher VPA response rate, better WCST performance, lower CRP level, and less MetS.ConclusionsThe study suggests a link between the peripheral MCN and cognitive function in BD patients. As an inflammatory status, MetS might modulate this association.     

认知负荷理论在医疗护理领域中应用的研究进展

从认知负荷的定义、分类、测量方法以及在医疗护理领域中的应用等方面对国外最新研究进展进行综述,旨在为我国医院管理者在改善医护人员实施治疗与护理措施时认知负荷的水平发挥积极作用提供理论依据。     

Patients' experiences across the trajectory of atrial fibrillation: A qualitative systematic review

AimThis study aimed to synthesize qualitative evidence on experiences of patients with atrial fibrillation (AF) during the course of diagnosis and treatment. We addressed three main questions: (a) What were the experiences of patients with AF during the course of diagnosis and treatment? (b) How did they respond to and cope with the disease? (c) What were the requirements during disease management?DesignIn this study, qualitative evidence synthesis was performed using the Thomas and Harden method.Data SourcesElectronic databases, including PubMed, the Cochrane Library, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, the China Biomedical Database, the WanFang Database, Chinese National Knowledge Infrastructure and VIP, were searched. The databases were searched from inception to August 2021.Review MethodsTwo researchers independently selected studies using qualitative assessment and review instruments for quality evaluation and thematic synthesis for the data analysis.ResultsA total of 2627 studies were identified in the initial search and 15 studies were included. Five analytical themes were generated: ‘Diagnosing AF’; ‘The impact of AF on the patients’; ‘Self‐reorientation in the therapeutic process’; ‘Living with AF and QoL’; and ‘External support to facilitate coping strategies.’ConclusionsOur findings point out unique experiences of patients across the trajectory of AF related to delayed diagnosis, feelings of nonsupport, disappointment of repeated treatment failure and multiple distress associated with unpredictable symptoms. Future research and clinical practice are expected to improve the quality of medical diagnosis and treatment, optimize administrative strategy and provide diverse health support for patients with AF.ImpactUnderstanding the experiences and needs of patients with AF in the entire disease process will inform future clinical practice in AF integrated management, which would be helpful in improving the professionalism and confidence of healthcare providers. In addition, our findings have implications for improving the effectiveness of AF diagnostic and treatment services.Patient or Public ContributionThis paper presents a review of previous studies and did not involve patients or the public.     

中药复方现代化研究的现状与基本思路

目的：提高中药复方配伍理论的源头创新,研制并推出具有独立自主知识产权的中药品种,促进中医药产业化和现代化。方法：以中医临床疗效确切的经典小复方为研究对象,运用现代科学技术手段,研究其体内外活性成分的组成,配伍机制以及构效关系和作用机制。结果：揭示中药复方效用及其配伍规律的科学内涵,全面提高中医临床疗效,提升中医药在我国医疗保健事业中的地位。结论：对于弘扬中医药学,并赋予其新的科学内涵,具有重要的学术和方法学意义。     

《中国卒中后认知障碍管理专家共识》解读

中国是卒中和痴呆的大国,卒中后认知障碍是卒中常见的并发症,不仅严重影响患者生活质量,而且显著降低卒中患者的生存时间,给家庭及社会带来了沉重的负担。卒中后早期干预可以减少血管性痴呆的发生,血管性因素的可控性为痴呆的治疗提供了新的思路。《中国卒中后认知障碍管理专家共识》将切实指导临床,使得卒中患者的生活质量得以提高。     

Brief Report: Adenosine A2A receptor blockade prevents cisplatin-induced impairments in neurogenesis and cognitive function

Chemotherapy-induced cognitive impairment (CICI) has emerged as a significant medical problem without therapeutic options. Using the platinum-based chemotherapy cisplatin to model CICI, we revealed robust elevations in the adenosine A_2A receptor (A_2AR) and its downstream effectors, cAMP and CREB, by cisplatin in the adult mouse hippocampus, a critical brain structure for learning and memory. Notably, A_2AR inhibition by the Food and Drug Administration–approved A_2AR antagonist KW-6002 prevented cisplatin-induced impairments in neural progenitor proliferation and dendrite morphogenesis of adult-born neurons, while improving memory and anxiety-like behavior, without affecting tumor growth or cisplatin’s antitumor activity. Collectively, our study identifies A_2AR signaling as a key pathway that can be therapeutically targeted to prevent cisplatin-induced cognitive impairments.     

Identification of Nordic Berries with Beneficial Effects on Cognitive Outcomes and Gut Microbiota in High-Fat-Fed Middle-Aged C57BL/6J Mice

High-fat diets are associated with neuronal and memory dysfunction. Berries may be useful in improving age-related memory deficits in humans, as well as in mice receiving high-fat diets. Emerging research has also demonstrated that brain health and cognitive function may be related to the dynamic changes in the gut microbiota. In this study, the impact of Nordic berries on the brain and the gut microbiota was investigated in middle-aged C57BL/6J mice. The mice were fed high-fat diets (60%E fat) supplemented with freeze-dried powder (6% dwb) of bilberry, lingonberry, cloudberry, blueberry, blackcurrant, and sea buckthorn for 4 months. The results suggest that supplementation with bilberry, blackcurrant, blueberry, lingonberry, and (to some extent) cloudberry has beneficial effects on spatial cognition, as seen by the enhanced performance following the T-maze alternation test, as well as a greater proportion of DCX-expressing cells with prolongation in hippocampus. Furthermore, the proportion of the mucosa-associated symbiotic bacteria Akkermansia muciniphila increased by 4–14 times in the cecal microbiota of mice fed diets supplemented with lingonberry, bilberry, sea buckthorn, and blueberry. These findings demonstrate the potential of Nordic berries to preserve memory and cognitive function, and to induce alterations of the gut microbiota composition.     

Depressive symptoms in amnesic mild cognitive impairment: an FDG-PET/CT study

IntroductionThe detection in mild cognitive impairment (MCI) of metabolic alterations suggestive of depression and/or of evolution to dementia.MethodsSixty-nine MCI patients underwent clinical and imaging evaluation including position emission tomography/computed tomography with fluorodeoxy-glucose (FDG-PET/CT).ResultsThe metabolism mean values in parietal, temporal and pre-cuneus areas were lower in subjects who evolved to dementia, and in frontal and in anterior cingulate areas in depressed subjects. Abnormal metabolism values were higher in the frontal and parietal lobes, and in the precuneus in subjects who evolved to dementia independently from depression.ConclusionsIn MCI FDG-PET/CT abnormality patterns suggest the presence of depression or the evolution to dementia.     

Modelling Strategies for Reinforced Concrete Elements under Corrosion Degradation

Aging and corrosion of reinforced concrete structures (RCS) is becoming a global problem, thus proper procedures for simulating the structural performance of corroded RCS should be assessed. Among the main corrosion effects, concrete cover cracking and reinforcement cross-section reduction may influence the materials’ constitutive laws, moreover the confinement contribution and the lateral instability of the longitudinal rebars can be modified. In the present paper, the predictive models available in the scientific literature to assess the materials’ mechanical properties of corroded RCS are recalled and employed into a novel model to derive the theoretical moment–curvature relationships for the cross-section of square and rectangular corroded reinforced concrete elements. The model accounts for cover spalling, buckling of longitudinal reinforcing bars, reduction in confinement pressures, reduction in concrete constitutive law due to the concrete cracking induced by rust formation and decay of mechanical properties for corroded reinforcements. The obtained results are compared with the classical simplified models for corroded RCS, highlighting that buckling and confinement variations cannot be disregarded into a reliable modelling strategy, especially when local ductility plays a key role in the performed investigations.     

The past,present, and future of sleep measurement in mild cognitive impairment and early dementia—towards a core outcome set: a scoping review

Study ObjectivesSleep abnormalities emerge early in dementia and may accelerate cognitive decline. Their accurate characterization may facilitate earlier clinical identification of dementia and allow for assessment of sleep intervention efficacy. This scoping review determines how sleep is currently measured and reported in Mild Cognitive Impairment (MCI) and early dementia, as a basis for future core outcome alignment.MethodsThis review follows the PRISMA Guidelines for Scoping Reviews. CINAHL, Embase, Medline, Psychinfo, and British Nursing Index databases were searched from inception—March 12, 2021. Included studies had participants diagnosed with MCI and early dementia and reported on sleep as a key objective/ outcome measure.ResultsNineteen thousand five hundred and ninety-six titles were returned following duplicate removal with 188 studies [N] included in final analysis. Sleep data was reported on 17 139 unique, diagnostically diverse participants (n). “Unspecified MCI” was the most common diagnosis amongst patients with MCI (n = 5003, 60.6%). Despite technological advances, sleep was measured most commonly by validated questionnaires (n = 12 586, N = 131). Fewer participants underwent polysomnography (PSG) (n = 3492, N = 88) and actigraphy (n = 3359, N = 38) with little adoption of non-PSG electroencephalograms (EEG) (n = 74, N = 3). Sleep outcome parameters were reported heterogeneously. 62/165 (37.6%) were described only once in the literature (33/60 (60%) in interventional studies). There was underrepresentation of circadian (n = 725, N = 25) and micro-architectural (n = 360, N = 12) sleep parameters.ConclusionsAlongside under-researched areas, there is a need for more detailed diagnostic characterization. Due to outcome heterogeneity, we advocate for international consensus on core sleep outcome parameters to support causal inference and comparison of therapeutic sleep interventions.