Different studies have reported varying alpha-synuclein values in the cerebrospinal fluid (CSF), serum, and plasma, making determination of the alpha-synuclein cutoff value for Parkinson's disease ...difficult and rendering identifying the cause of variation essential.
We searched PubMed from inception to June 2021 and identified 76 eligible studies. Included studies reported data on total, phosphorylated, and oligomeric alpha-synuclein in the CSF, serum, or plasma from individuals with Parkinson's disease and healthy controls. The mean or median alpha-synuclein values from the included studies were summarized and categorized through laboratory assays to visualize potential trends.
The enzyme-linked immunosorbent assay (ELISA) is the most common assay used to determine alpha-synuclein concentrations. Less common assays include Luminex, single molecule arrays, electrochemiluminescence, and immunomagnetic reduction (IMR). IMR is a single-antibody and wash-free immunoassay designed for determining the extremely low concentration of bio-molecules. For patients with Parkinson's disease, the median or mean testing values ranged from 60.9 to 55,000 pg/mL in the CSF, 0.446 to 1,777,100 pg/mL in plasma, and 0.0292 to 38,200,000 pg/mL in serum. The antibody selection was diverse between studies. The tendency of distribution was more centralized among studies that used the same kit. Studies adopting specific antibodies or in-house assays contribute to the extreme values. Only a few studies on phosphorylated and oligomeric alpha-synuclein were included.
The type of assay and antibody selection in the laboratory played major roles in the alpha-synuclein variation. Studies that used the same assay and kit yielded relatively unanimous results. Furthermore, IMR may be a promising assay for plasma and serum alpha-synuclein quantification. A consensus on sample preparation and testing protocol unification is warranted in the future.
•Different studies have reported varying alpha-synuclein values in the cerebrospinal fluid (CSF), serum, and plasma.•The type of assay and antibody selection in the laboratory played major roles in the alpha-synuclein variation.•IMR may be a promising assay for cases of extremely low analyte concentrations in serum and plasma.•A consensus on sample preparation and testing protocol unification is warranted in the future.
Stroke is an important risk factor for dementia. Epidemiological studies have indicated a high incidence of dementia in stroke patients. There is currently no effective biomarker for the diagnosis of ...post-stroke dementia (PSD). D-amino acid oxidase (DAO) is a flavin-dependent enzyme widely distributed in the central nervous system. DAO oxidizes D-amino acids, a process which generates neurotoxic hydrogen peroxide and leads to neurodegeneration. This study aimed to examine post-stroke plasma DAO levels as a biomarker for PSD. In total, 53 patients with PSD, 20 post-stroke patients without dementia (PSNoD), and 71 age- and gender-matched normal controls were recruited. Cognitive function was evaluated at more than 30 days post-stroke. Plasma DAO was measured using the enzyme-linked immunosorbent assay. White matter hyperintensity (WMH), a neuroimaging biomarker of cerebral small vessel diseases, was determined by magnetic resonance imaging. We found that plasma DAO levels were independently higher in PSD subjects than in PSNoD subjects or the controls and were correlated with the WMH load in stroke patients. Using an area under the curve (AUC)/receiver operating characteristic analysis, plasma DAO levels were significantly reliable for the diagnosis of PSD. The sensitivity and specificity of the optimal cut-off value of 321 ng/ml of plasma DAO for the diagnosis of PSD were 75 and 88.7%, respectively. In conclusion, our data support that plasma DAO levels were increased in PSD patients and correlated with brain WMH, independent of age, gender, hypertension, and renal function. Plasma DAO levels may therefore aid in PSD diagnosis.
White matter hyperintensities (WMHs) include periventricular WMH (pvWMH) and deep WMH. When hyperintensities in the basal ganglia or brainstem are included, the collective term is subcortical ...hyperintensities. Both WMH and medial temporal lobe atrophy (MTA) are risk factors for cognitive decline. This prospective study enrolled participants aged 50–85 years and followed their neuropsychological assessments annually for 2 years to explore the interactive effects of WMH and MTA on longitudinal clinical decline. Brain MRI was performed at the beginning of enrollment. Of the 200 participants, 57 were “normal” individuals, 40 had dysexecutive mild cognitive impairment, 53 had amnestic mild cognitive impairment, and 50 had Alzheimer’s disease (AD). Overall, MTA significantly correlated with pvWMH (p=0.0004) but not with deep WMH, as defined by criteria using the Scheltens’ Scale. Total Scheltens’ score was specifically associated with the domain of semantic fluency (beta=−0.4, 95% CI=–0.7 to –0.2, p=0.002), which remained significant when adjusting for MTA (beta=−0.3, 95% CI=–0.5 to –0.1, p=0.017). The pvWMH was significantly higher in AD subjects than in normal control subjects (beta=0.3, 95% CI=0.1 to 0.4, p=0.001), especially the periventricular occipital caps (beta=0.2, 95% CI=0.1 to 0.3, p=0.0003). Cox proportional hazards model showed that the periventricular bands (PVB) predicted 1-year clinical decline (hazard ratio HR=5.3, 95% CI=1.8 to 15.7, p=0.002), which remained significant when further adjusting for MTA (HR=4.0, 95% CI=1.3 to 12.1, p=0.013). In summary, pvWMH, especially the occipital caps, was correlated with MTA and the AD subgroup. Assessment of semantic fluency may be useful for the clinical evaluation of the degree of subcortical hyperintensity burden. Visual rating of PVB could be an independent predictor for 1-year clinical decline.
Abstract The thyroid is an unusual site to find cancer metastasis. When it does occur, such cancer spread is often manifested in multiple metastases and generally suggests a poor prognosis. We ...presented here a 49-year-old woman recently diagnosed with thyroid cancer, who had been treated for stage IIA breast cancer 8 years ago. After radical right thyroidectomy and left subtotal thyroidectomy, her pathological report showed papillary thyroid carcinoma, right thyroid, with concomitant metastatic breast carcinoma. This is the first case of which we are aware involving coexisting thyroid cancer and metastatic breast cancer in the ipsilateral lobe. Moreover, the circumstances of this case show a very unique clinical course compared with previous studies. Given the unusual circumstances of our case, we further discuss the relationship between thyroid cancer and breast cancer.
Background The risk of post-thrombotic syndrome and pulmonary embolism can be increased if there is failure to diagnose deep venous thrombosis (DVT) promptly. Emergency physicians (EPs) need a quick ...and readily available test to diagnose, treat and help them decide whether to discharge or admit DVT patients in a timely manner. The aim of this study was to investigate the value of the non-compressibility ratio of thrombosed veins in DVT patients, and give EPs an objective value to aid them in their decision-making with regard to DVT patients in the emergency department. Methods We reviewed 34 adult patients with DVT diagnosed by sonography in an emergency department. Medical records including demographic data and sonography results were retrospectively reviewed and analyzed. Results Mean age was 72.9 ± 16.5 years. Group I comprised 14 patients (41.2%) who had DVT in the popliteal and femoral veins. Group II comprised 8 patients (23.5%) who had DVT isolated to the popliteal vein and 12 patients (35.3%) who had DVT isolated to the femoral vein. Group I had a significantly higher non-compressibility ratio than Group II (93.4 ± 6.2% vs. 80.1 ± 19.2%, p < 0.05). The area under the receiver operating characteristic curve of the non-compressibility ratio between discriminating groups was 0.711 (95% confidence interval, 0.527-0.854; p < 0.05). The clinical prognostic score of Group I was significantly higher than that of Group II (6.2 ± 1.8 vs. 4.1 ± 2.6, p < 0.05). There was a significant positive correlation between the non-compressibility ratio of the thrombosed vein and the clinical prognostic score ( p = 0.001). Conclusion The non-compressibility ratio of the thrombosed vein provides EPs with an objective test to evaluate the severity of DVT and to admit patients for consideration of adverse outcomes.
The thyroid is an unusual site to find cancer metastasis. When it does occur, such cancer spread is often manifested in multiple metastases and generally suggests a poor prognosis. We presented here ...a 49-year-old woman recently diagnosed with thyroid cancer, who had been treated for stage IIA breast cancer 8 years ago. After radical right thyroidectomy and left subtotal thyroidectomy, her pathological report showed papillary thyroid carcinoma, right thyroid, with concomitant metastatic breast carcinoma. This is the first case of which we are aware involving coexisting thyroid cancer and metastatic breast cancer in the ipsilateral lobe. Moreover, the circumstances of this case show a very unique clinical course compared with previous studies. Given the unusual circumstances of our case, we further discuss the relationship between thyroid cancer and breast cancer., 甲狀腺是一個不尋常的癌症轉移位置。甲狀腺被癌症轉移通常發生在已有他處轉移的情況下，而且一般預後不佳。我們舉出一位49歲的女性，曾在八年前罹患第二期乳癌並接受過手術與化學治療。她後來被診斷出罹患甲狀腺癌。經過右側甲狀腺根除術與左側次全甲狀腺切除術。病理報告顯示，右側乳突性甲狀腺癌，同時伴隨乳癌轉移至右
Hypertension‐related death is the leading cause of mortality worldwide, making blood pressure (BP) control an important issue. Salt substitute is a non‐pharmaceutical strategy to improve hypertension ...control. The goal of this study was to evaluate the effect of salt substitute on BP and cardiovascular disease. The authors searched the Cochrane Library and PubMed databases through March 2022, and assessed the risk‐of‐bias for included studies by the Cochrane risk‐of‐bias tool. Twenty‐three randomized controlled trials with 32073 patients were included in our systematic review. A meta‐analysis with random effects was performed to analyze the effects of salt substitute on systolic and diastolic BP, 24‐h urinary sodium and potassium, and cardiovascular and all‐cause mortality. In the random‐effects model, participants consuming salt substitute showed significant reduction in systolic BP (mean difference (MD) −4.80 mmHg, 95% confidence interval (CI) −6.12 to −3.48, P < 0.0001) and diastolic BP (MD −1.48 mmHg, 95% CI −2.06 to −0.90, P < 0.0001) compared with participants consuming normal salt. In the urine electrolyte analysis, the salt substitute group had significant reduction in 24‐h urine sodium (MD −22.96 mmol/24‐h, P = 0.0001) and significant elevation in 24‐h urine potassium (MD 14.41 mmol/24‐h, P < 0.0001). Of the five studies with mortality outcome data, salt substitute significantly reduced all‐cause mortality (hazard ratio 0.88, P = 0.0003). In conclusion, our analyses showed that salt substitute has a strong effect on lowering BP and reducing all‐cause mortality. By modifying the daily diet with salt substitute, the authors can improve BP control by using this non‐pharmaceutical management.
In this paper we report the effect on the power conversion efficiency (PCE) and stability of photovoltaic devices after incorporating hydrogenated two-dimensional (2D) MoSe2 nanosheets into the ...active layer of bulk heterojunction (BHJ) organic photovoltaics (OPV). The surface properties of 2D MoSe2 nanosheets largely affect their dispersion in the active layer blend and, thus, influence the carrier mobility, PCE, and stability of corresponding devices. We treated MoSe2 nanosheets with hydrogen plasma and investigated their influence on the polymer packing and fullerene domain size of the active layer. For the optimized devices incorporating 37.5 wt% of untreated MoSe2, we obtained a champion PCE of 9.82%, compared with the champion reference PCE of approximately 9%. After incorporating the hydrogen plasma-treated MoSe2 nanosheets, we achieved a champion PCE of 10.44%—a relative increase of 16% over that of the reference device prepared without MoSe2 nanosheets. This PCE is the one of the highest ever reported for OPVs incorporating 2D materials. We attribute this large enhancement to the enhanced exciton generation and dissociation at the MoSe2–fullerene interface and, consequently, the balanced charge carrier mobility. The device incorporating the MoSe2 nanosheets maintained 70% of its initial PCE after heat-treatment at 100 °C for 1 h; in contrast, the PCE of the reference device decreased to 60% of its initial value—a relative increase in stability of 17% after incorporating these nanosheets. We also incorporated MoSe2 nanosheets (both with and without treatment) into a polymer donor (PBDTTBO)/small molecule (IT-4F) acceptor system. The champion PCEs reached 7.85 and 8.13% for the devices incorporating the MoSe2 nanosheets with and without plasma treatment, respectively—relative increases of 8 and 12%, respectively, over that of the reference. These results should encourage a push toward the implementation of transition metal dichalcogenides to enhance the performances of BHJ OPVs.
•The estimated prevalence of sarcopenia in RA was 31%, without significant differences between various living area and diagnostic modalities.•Disease duration, DAS28 and HAQ were predictors of ...sarcopenia development in patients with RA.•Functional limitation, CRP and RF seropositivity were identified as additional risk factors.
Sarcopenia is an ever-increasingly recognized entity in aging or chronically-ill individuals. A recent surge of researches came out on sarcopenia in rheumatoid arthritis (RA). However, the results varied widely. We tried to assess the prevalence of and associated factors with sarcopenia in patients with RA.
We searched the investigations dealing with the prevalence of and associated factors with sarcopenia in RA from PubMed, EMBASE, CENTRAL, EBSCOhost, Airiti Library, CEPS, CNKI and J-STAGE from the inception to January 11, 2020. Effects regarding prevalence and associated factors were extracted and evaluated by random-effects model. Sensitivity analysis was also performed.
Seventeen studies containing 3,140 RA subjects were identified. After exclusion of outliers, the pooled prevalence of sarcopenia was 31%. Neither ongoing-study districts nor diagnostic modalities affected prevalence significantly. Any associated factors being mentioned in at least two publications were analyzed, yielding functional limitation (Steinbrocker stage III/IV), high CRP and RF seropositivity as the significant risk factors. Based on disease durations, we carried out meta-regression and found DAS28 and HAQ are predictive models. There was no alteration in the interpretation of results from sensitivity analysis after removal of any studies skewed in sampling distribution.
The prevalence of sarcopenia in patients with RA is high, compared to that in general counterparts. Disease duration rather than age, residing area or diagnostic modalities influences sarcopenia development; DAS28 and HAQ predict occurrence. High index of suspicion to facilitate early detection of sarcopenia in RA patients is important.
Carnivore protoparvovirus 1 includes feline parvovirus (FPV), variants of canine parvovirus‐2 (CPV‐2), mink enteritis virus, and raccoon parvovirus, important pathogens affecting both wild and ...domestic carnivores. In this report, we described a fatal CPV‐2 infection in a rescued Taiwanese pangolin, which provides the first evidence of CPV‐2 infection in a non‐carnivore. Post‐rescue, the Taiwanese pangolin died from complications resulting from a severe panleucocytopenia and bloody diarrhoea. A full autopsy was performed and microscopic examination of the tissues revealed ulcerative, necrotizing, and haemorrhagic glossitis, esophagitis and enteritis. The results of transmission electronic microscopy, polymerase chain reaction and in situ hybridization provided confirmatory evidence that the lesions in the tongue, oesophagus and intestine were associated with a protoparvovirus. Phylogenetic comparison of the whole VP2 gene from the current pangolin protoparvovirus strain showed close clustering with the CPV‐2c strains from domestic dogs in Taiwan, China and Singapore. The amino acid sequence of the pangolin protoparvovirus showed 100% identity to the CPV‐2c strains from domestic dogs in China, Italy, and Singapore. The current findings highlight that pangolins are susceptible to protoparvoviruses. The potential of cross‐species transmission of protoparvoviruses between Carnivora and Pholidota should be considered when housing pangolins in close proximity to carnivores and adopting strict biosecurity measures to avoid cross‐species transmission in rescue facilities and zoos.
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