In this 2-year trial involving patients with Parkinson's disease and early motor complications, subthalamic stimulation plus medical therapy resulted in better quality of life and motor function than ...medical therapy alone.
Parkinson's disease is a progressive neurodegenerative disease that affects dopaminergic neurotransmission, resulting in bradykinesia, rigidity, and rest tremor. After an initial honeymoon period, during which there is a sustained response to dopaminergic treatment, beneficial effects are hampered by levodopa-induced motor complications,
1
progressively compromising quality of life.
2
–
4
Because levodopa-responsive parkinsonian symptoms are improved by high-frequency stimulation of the subthalamic nucleus,
5
,
6
neurostimulation has become an established treatment for advanced Parkinson's disease with medically intractable fluctuations and dyskinesia
7
–
10
and has shown long-term efficacy.
11
–
13
It is typically used after the disease has been present for 11 to 13 years,
7
– . . .
•Mass administration of ivermectin is associated with lower COVID-19 incidence.•Ivermectin has been shown to inhibit SARS-CoV-2 replication in vitro.•Ivermectin may have a prophylactic effect against ...COVID-19.•COVID-19 prophylaxis could help bridge the time until a vaccine becomes widely available.
As COVID-19 (coronavirus disease 2019) continues to rapidly spread throughout the world, the incidence varies greatly among different countries. These differences raise the question whether nations with a lower incidence share any medical commonalities that could be used not only to explain that lower incidence but also to provide guidance for potential treatments elsewhere. Such a treatment would be particularly valuable if it could be used as a prophylactic against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) transmission, thereby effectively slowing the spread of the disease while we await the wide availability of safe and effective vaccines. Here, we show that countries with routine mass drug administration of prophylactic chemotherapy including ivermectin have a significantly lower incidence of COVID-19. Prophylactic use of ivermectin against parasitic infections is most common in Africa and we hence show that the reported correlation is highly significant both when compared among African nations as well as in a worldwide context. We surmise that this may be connected to ivermectin's ability to inhibit SARS-CoV-2 replication, which likely leads to lower infection rates. However, other pathways must exist to explain the persistence of such an inhibitory effect after serum levels of ivermectin have declined. It is suggested that ivermectin be evaluated for potential off-label prophylactic use in certain cases to help bridge the time until a safe and effective vaccine becomes available.
Double Chooz is a reactor antineutrino disappearance experiment located in Chooz, France. A far detector at a distance of about 1 km from reactor cores is operating since 2011; a near detector of ...identical design at a distance of about 400 m is operating since begin 2015. Beyond the precise measurement of θ13, Double Chooz has a strong sensitivity to so called light sterile neutrinos. Sterile neutrinos are neutrino mass states not taking part in weak interactions, but may mix with known neutrino states. In this paper, we present an analysis method to search for sterile neutrinos and the expected sensitivity with the baselines of our detectors.
We present a search for signatures of neutrino mixing of electron anti-neutrinos with additional hypothetical sterile neutrino flavors using the Double Chooz experiment. The search is based on data ...from 5 years of operation of Double Chooz, including 2 years in the two-detector configuration. The analysis is based on a profile likelihood, i.e. comparing the data to the model prediction of disappearance in a data-to-data comparison of the two respective detectors. The analysis is optimized for a model of three active and one sterile neutrino. It is sensitive in the typical mass range
5
×
10
-
3
eV
2
≲
Δ
m
41
2
≲
3
×
10
-
1
eV
2
for mixing angles down to
sin
2
2
θ
14
≳
0.02
. No significant disappearance additionally to the conventional disappearance related to
θ
13
is observed and correspondingly exclusion bounds on the sterile mixing parameter
θ
14
as a function of
Δ
m
41
2
are obtained.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In idiopathic Parkinson's disease (PD), a tremor-dominant type (TDT), an akinetic-rigid type (ART), and a mixed type (MT) are distinguished. We compared cerebral I-123FP-CIT SPECT in the PD subtypes ...(67 patients Hoehn and Yahr stage 1:26 with ART, 19 with MT, 22 with TDT). We measured the ratios putamen/occipital lobe binding and caudate nucleus/occipital lobe binding. Parkinsonian motor symptoms were quantified by UPDRS motor scale. In both putamen and caudate nucleus contralateral to the clinically affected body side TDT patients showed a significantly higher FP-CIT uptake than ART or MT patients (ANOVA; p<0.01). Contralateral putamen and caudate nucleus FP-CIT uptake correlated significantly with severity of rigidity (p<0.01) and hypokinesia (p<0.01) but not with severity of resting or postural tremor (p>0.05). The missing correlation between striatal FP-CIT uptake and tremor suggests, that further systems besides the nigrostriatal dopaminergic system may contribute to generation of parkinsonian tremor.
A
bstract
A
θ
13
oscillation analysis based on the observed antineutrino rates at the Double Chooz far and near detectors for different reactor power conditions is presented. This approach provides a ...so far unique simultaneous determination of
θ
13
and the total background rates without relying on any assumptions on the specific background contributions. The analysis comprises 865 days of data collected in both detectors with at least one reactor in operation. The oscillation results are enhanced by the use of 24.06 days (12.74 days) of reactor-off data in the far (near) detector. The analysis considers the
ν
¯
e
interactions up to a visible energy of 8.5 MeV, using the events at higher energies to build a cosmogenic background model considering fast-neutrons interactions and
9
Li decays. The background-model-independent determination of the mixing angle yields sin
2
(2
θ
13
) = 0
.
094 ± 0
.
017, being the best-fit total background rates fully consistent with the cosmogenic background model. A second oscillation analysis is also performed constraining the total background rates to the cosmogenic background estimates. While the central value is not significantly modified due to the consistency between the reactor-off data and the background estimates, the addition of the background model reduces the uncertainty on
θ
13
to 0.015. Along with the oscillation results, the normalization of the anti-neutrino rate is measured with a precision of 0.86%, reducing the 1.43% uncertainty associated to the expectation.
A
bstract
The yields and production rates of the radioisotopes
9
Li and
8
He created by cosmic muon spallation on
12
C, have been measured by the two detectors of the Double Chooz experiment. The ...identical detectors are located at separate sites and depths, which means that they are subject to different muon spectra. The near (far) detector has an overburden of ∼120 m.w.e. (∼300 m.w.e.) corresponding to a mean muon energy of 32.1 ± 2.0 GeV (63.7 ± 5.5 GeV). Comparing the data to a detailed simulation of the
9
Li and
8
He decays, the contribution of the
8
He radioisotope at both detectors is found to be compatible with zero. The observed
9
Li yields in the near and far detectors are 5.51 ± 0.51 and 7.90 ± 0.51, respectively, in units of 10
−8
μ
−1
g
−1
cm
2
. The shallow overburdens of the near and far detectors give a unique insight when combined with measurements by KamLAND and Borexino to give the first multi-experiment, data driven relationship between the
9
Li yield and the mean muon energy according to the power law
Y
=
Y
0
E
μ
/
1
GeV
α
¯
, giving
α
¯
=
0.72
±
0.06
and
Y
0
= (0.43 ± 0.11) × 10
−8
μ
−1
g
−1
cm
2
. This relationship gives future liquid scintillator based experiments the ability to predict their cosmogenic
9
Li background rates.
Genetic counseling and genetic testing are important tools for diagnosis, screening, and employment of effective medical management strategies for hereditary cardiovascular diseases. Despite ...widespread recognition of the benefits of genetic counseling and testing in cardiovascular care, little is published regarding their use in large healthcare systems. We conducted a retrospective cross-sectional study using administrative claims data in the US Military Health System to assess the state of recommended genomic counseling in clinical cardiovascular care. Logistic regression models were used to examine associations of genetic counseling among beneficiaries with hereditary cardiovascular conditions. Approximately 0.44% of beneficiaries in fiscal year 2018 had a diagnosis of a hereditary cardiovascular condition. Among the 23,364 patients with a diagnosis of hereditary cardiovascular disease, only 175 (0.75%) had documented genetic counseling and 196 (0.84%) had documented genetic testing. Genetic counseling did not differ by race, sex, service, or diagnosis. Age group, Active Duty status, rank as a proxy for socioeconomic status, and geographic location contributed significantly to the likelihood of receiving genetic counseling. These findings suggest that genetic counseling is underutilized in clinical cardiovascular care in the Military Health System and may be more broadly, despite expert consensus recommendations for its use and potential life-saving benefits. Unlike previous studies in the US civilian health sector, there did not appear to be disparities in genetic counseling by race or sex in the Military Health System. Strategies to improve care for cardiovascular disease should address the underutilization of recommended genetics evaluations for heritable diagnoses and the challenges of assessing use in large health systems studies.
The aim of this study was to determine the predictive values of 2-fluorine-18fluoro-2-deoxy-D-glucose–positron emission tomography (FDG–PET) in primary staging in patients with newly diagnosed ...non-seminomatous germ cell tumour (NSGCT) clinical stage I/II.
The hypothesis was that FDG–PET would improve the negative predictive value (NPV) from 70% to 90%, thus requiring a total of 169 patients. All scans underwent visual analysis by a reference team of nuclear medicine physicians. Results were validated by histology following retroperitoneal lymph node dissection.
Only 72 of the planned 169 patients were included, due to poor accrual. The prevalence of nodal involvement was 26%. Correct nodal staging by FDG–PET was achieved in 83% compared with correct computed tomography (CT) staging in 71%. CT had a sensitivity and specificity of 41% and 95%, respectively. Positive predictive value (PPV) and NPV were 87% and 67%, respectively. FDG–PET had a sensitivity and specificity of 66% and 98%, respectively. PPV was 95%. The primary end point was not reached, with an NPV of 78%.
FDG–PET as a primary staging tool for NSGCT yielded only slightly better results than CT. Both methods had a high specificity while false-negative findings were more frequent with CT. FDG–PET is mostly useful as a diagnostic tool in case of questionable CT scan.
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