Renal cell carcinoma (RCC) is the most common type of cancer in kidney and is often diagnosed in advanced stages. Until now, there is no reliable biomarker to assess tumor prognosis during ...histopathological diagnosis. The Methylenetetrahydrofolate dehydrogenase 2 (MTHFD2) overexpression has been suggested as prognostic indicator for RCC, however, its protein profile needs to be clarified. This study investigated the MTHFD2 expression in different RCC cohorts, associating it with tumor characteristics and prognostic factors. Gene expression comparisons between non-neoplastic (NN) and tumor samples, as well as patients' survival analysis, were assessed using KM-Plotter tool. MTHFD2 protein pattern was evaluated in 117 RCC by immunohistochemistry and associations with prognosis, clinical and pathological data were investigated. The tumors exhibited higher MTHFD2 transcript levels than NN, being even higher in the metastatic group. Opposite gene expression patterns were found among clear cell renal cell carcinoma (ccRCC) and pappilary renal cell carcinoma (pRCC) subtypes, showing higher and lower expressions compared to NN samples respectively. Overexpression was associated with shorter overall survival for ccRCC and pRCC subtypes, and shorter recurrence-free survival for pRCC. The immunolabeling profile varied according to tumor subtypes, with lower intensity and expression scores in ccRCC compared to pRCC and to chromophobe renal cell carcinoma (chRCC). MTHFD2 protein expression was associated with larger tumors and higher Fuhrman grades. Although prognostic value of protein immunostaining was not confirmed, patients with higher MTHFD2 tended to have lower survival rates in the pRCC group. The results highlight MTHFD2 different patterns according to RCC histological subtypes, revealing marked variations at both the genetic and protein levels. The mRNA indicated tumor prognosis, and greater expression in the tumor samples. Although MTHFD2 immunolabeling suggests tumor aggressiveness, it needs to be validated in other cohorts as potential prognostic factor.
Measures of social cognition have now become central in neuropsychology, being essential for early and differential diagnoses, follow-up, and rehabilitation in a wide range of conditions. With the ...scientific world becoming increasingly interconnected, international neuropsychological and medical collaborations are burgeoning to tackle the global challenges that are mental health conditions. These initiatives commonly merge data across a diversity of populations and countries, while ignoring their specificity. Objective: In this context, we aimed to estimate the influence of participants' nationality on social cognition evaluation. This issue is of particular importance as most cognitive tasks are developed in highly specific contexts, not representative of that encountered by the world's population. Method: Through a large international study across 18 sites, neuropsychologists assessed core aspects of social cognition in 587 participants from 12 countries using traditional and widely used tasks. Results: Age, gender, and education were found to impact measures of mentalizing and emotion recognition. After controlling for these factors, differences between countries accounted for more than 20% of the variance on both measures. Importantly, it was possible to isolate participants' nationality from potential translation issues, which classically constitute a major limitation. Conclusions: Overall, these findings highlight the need for important methodological shifts to better represent social cognition in both fundamental research and clinical practice, especially within emerging international networks and consortia.
Key Points
Question: We estimate the influence of cultural factors on social cognition assessment. Findings: Participants' nationality accounted for more than 20% of the variance of social cognition scores. Importance: Cognitive tasks are developed in highly specific contexts and should not be used in other cultures without adaptations. Next Steps: Finer-grain analyses of cross-cultural variations coupled with neural correlates of performances' convergences and divergences.
Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) share cognitive and behavioral symptoms, such as apathy. Social cognition measurements are useful in distinguishing ...bvFTD from AD, but their accuracies may be affected by apathy.
To investigate whether social cognition measurements can distinguish bvFTD from either apathetic or non-apathetic AD patients.
Three groups of participants were enrolled in the present study: bvFTD (n = 22), AD (n = 20), and healthy controls (HC, n = 23). The AD group was divided into apathetic (n = 10) and non-apathetic (n = 10). All subjects underwent comprehensive neuropsychological examination, including the short version of the Social and Emotional Assessment (Mini-SEA), which comprises the facial emotion recognition test and the faux-pas recognition test (Faux-Pas Test). Apathy was assessed according to the Starkstein's Apathy (SA) Scale.
The bvFTD and AD groups did not differ on global cognitive efficiency and on executive functions. In comparison to the whole AD group, bvFTD displayed lower Faux-Pas Test and Mini-SEA scores. Both AD subgroups, apathetic or non-apathetic, exhibited similar performance on all social cognition measurements. In comparison to either apathetic AD or non-apathetic AD, bvFTD patients underperformed on the Faux-Pas Test and on the Mini-SEA. The area under the curve values for the Mini-SEA total score were 0.87 (bvFTD versus AD), 0.90 (bvFTD versus apathetic AD), and 0.83 (bvFTD versus non-apathetic AD).
Social cognition tests provide accurate distinction between bvFTD against either apathetic AD or non-apathetic AD. Social cognition measurements did not correlate with apathy severity.
Background
Decades of researches aiming to unveil truths about human neuropsychology may have instead unveil facts appropriate to only a fraction of the world’s population: those living in western ...educated rich democratic nations (Muthukrishna et al., 2020 Psych Sci). So far, most studies were conducted as if education and cultural assumptions on which neuropsychology is based were universals and applied everywhere in the world. The importance given to sociological or cultural factors is thus still relatively ignored. With the growth of international clinical studies on dementia, we believe that documenting the potential inter‐cultural differences at stake in a common neuropsychological assessment is an essential topic. This study thus aimed to explore these potential variations in two classical tasks used in neuropsychology that are composing the mini‐SEA (Bertoux et al., 2012 JNNP), i.e. a reduced version of the well‐known Ekman faces (FER), where one has to recognize facial emotions, and a modified version of the Faux Pas test (mFP), where one has to detect and explain social faux.
Method
The data of 573 control participants were collected through the Social Cognition & FTLD Network, an international consortium investigating social cognitive changes in dementia covering 3 continents (18 research centres in 12 countries). Impact of demographic factors and the effect of countries on performance (mini‐SEA, FER, mFP) were explored through linear mixed‐effects models.
Result
Age, education and gender were found to significantly impact the performance of the mini‐SEA subtests. Significant and important variations across the countries were also retrieved, with England having the highest performance for all scores. When controlling for demographical factors, differences within countries explained between 14% (mFP) and 24% (FER) of the variance at the mini‐SEA. These variations were not explained by any economical or sociological metrics.
Conclusion
Important variations of performance were observed across the 12 countries of the consortium, showing how cultural differences may critically impact neuropsychological performance in international studies.
Abstract
Background
Decades of researches aiming to unveil truths about human neuropsychology may have instead unveil facts appropriate to only a fraction of the world’s population: those living in ...western educated rich democratic nations (Muthukrishna et al., 2020 Psych Sci). So far, most studies were conducted as if education and cultural assumptions on which neuropsychology is based were universals and applied everywhere in the world. The importance given to sociological or cultural factors is thus still relatively ignored. With the growth of international clinical studies on dementia, we believe that documenting the potential inter‐cultural differences at stake in a common neuropsychological assessment is an essential topic. This study thus aimed to explore these potential variations in two classical tasks used in neuropsychology that are composing the mini‐SEA (Bertoux et al., 2012 JNNP), i.e. a reduced version of the well‐known Ekman faces (FER), where one has to recognize facial emotions, and a modified version of the Faux Pas test (mFP), where one has to detect and explain social faux.
Method
The data of 573 control participants were collected through the Social Cognition & FTLD Network, an international consortium investigating social cognitive changes in dementia covering 3 continents (18 research centres in 12 countries). Impact of demographic factors and the effect of countries on performance (mini‐SEA, FER, mFP) were explored through linear mixed‐effects models.
Result
Age, education and gender were found to significantly impact the performance of the mini‐SEA subtests. Significant and important variations across the countries were also retrieved, with England having the highest performance for all scores. When controlling for demographical factors, differences within countries explained between 14% (mFP) and 24% (FER) of the variance at the mini‐SEA. These variations were not explained by any economical or sociological metrics.
Conclusion
Important variations of performance were observed across the 12 countries of the consortium, showing how cultural differences may critically impact neuropsychological performance in international studies.
Patients with mild traumatic brain injury (mTBI) may present cognitive deficits within the first 24 h after trauma, herein called "acute phase," which in turn may lead to long-term functional ...impairment and decrease in quality of life. Few studies investigated cognition in mTBI patients during the acute phase. The objectives of this study were to investigate the cognitive profile of patients with mTBI during the acute phase, compared to controls and normative data, and whether loss of consciousness (LOC), previous TBI and level of education influence cognition at this stage. Fifty-three patients with mTBI (aged 19-64 years) and 28 healthy controls participated in the study. All patients were evaluated at bedside within 24 h post-injury. Demographic and clinical data were registered. Cognitive function was assessed with the Mini-mental state examination (MMSE), the Frontal Assessment Battery (FAB), Digit Span (working memory), and the Visual Memory Test/Brief Cognitive Battery (for episodic memory). The clinical sample was composed mainly by men (58.5%). The mean age was 39 years-old and 64.3% of the patients had more than 8 years of education. The most common causes of mTBI were fall from own height (28.3%), aggression (24.5%), and fall from variable heights (24.5%). Compared to controls, mTBI patients exhibited significantly worse performance on MMSE, FAB, naming, incidental memory, immediate memory, learning, and delayed recall. Compared to normative data, 26.4% of patients had reduced global cognition as measured by the MMSE. Episodic memory impairment (13.2%) was more frequent than executive dysfunction (9.4%). No significant differences were found in cognitive performance when comparing patients with or without LOC or those with or without history of previous TBI. Patients with lower educational level had higher rates of cognitive impairment (VMT naming-28.6 vs. 4.2%; VMT immediate memory-32 vs. 4.2%; VMT learning-39.3 vs. 4.2%, all
< 0.05). In sum, we found significant cognitive impairment in the acute phase of mTBI, which was not associated with LOC or history of TBI, but appeared more frequently in patients with lower educational level.
Background
During the COVID-19 pandemic, creating tools to assess disease severity is one of the most important aspects of reducing the burden on emergency departments. Lung ultrasound has a high ...accuracy for the diagnosis of pulmonary diseases; however, there are few prospective studies demonstrating that lung ultrasound can predict outcomes in COVID-19 patients. We hypothesized that lung ultrasound score (LUS) at hospital admission could predict outcomes of COVID-19 patients. This is a prospective cohort study conducted from 14 March through 6 May 2020 in the emergency department (ED) of an urban, academic, level I trauma center. Patients aged 18 years and older and admitted to the ED with confirmed COVID-19 were considered eligible. Emergency physicians performed lung ultrasounds and calculated LUS, which was tested for correlation with outcomes. This protocol was approved by the local Ethics Committee number 3.990.817 (CAAE: 30417520.0.0000.0068).
Results
The primary endpoint was death from any cause. The secondary endpoints were ICU admission and endotracheal intubation for respiratory failure. Among 180 patients with confirmed COVID-19 who were enrolled (mean age, 60 years; 105 male), the average LUS was 18.7 ± 6.8. LUS correlated with findings from chest CT and could predict the estimated extent of parenchymal involvement (mean LUS with < 50% involvement on chest CT, 15 ± 6.7 vs. 21 ± 6.0 with > 50% involvement,
p
< 0.001), death (AUC 0.72, OR 1.13, 95% CI 1.07 to 1.21; p < 0.001), endotracheal intubation (AUC 0.76, OR 1.17, 95% CI 1.09 to 1.26;
p
< 0.001), and ICU admission (AUC: 0.71, OR 1.14, 95% CI 1.07 to 1.21;
p
< 0.001).
Conclusions
In COVID-19 patients admitted in ED, LUS was a good predictor of death, ICU admission, and endotracheal intubation.
Background: Metabolic syndrome (MS) is associated with greater risk of morbimortality and it has high prevalence in people with mental illness. Objective: Estimate the prevalence of Metabolic ...Syndrome (MS) and its associated factors in the patients of a Psychosocial Care Center (CAPS in Brazilian Portuguese) in the city of Salvador, state of Bahia, Brazil. Method: Cross-sectional study set at CAPS in the city of Salvador-Bahia between August 2019 and February 2020. MS was evaluated according to the National Cholesterol Education Program’s Adult Treatment Panel III. In addition to descriptive statistics, gross and adjusted prevalence ratios were described. Results: MS was found in 100 (35.2%) individuals, 116 (40.9%) were obese and 165 (58.1%) had increased waist circumference. Polypharmacy was identified in 63 (22.3%) patients and 243 (85.9%) used antipsychotics. Under gross evaluation, women (PR = 1.88; 95%CI: 1.35–2.63) and those who used antidepressants (PR = 1.41; 95%CI: 1.05–1.88) showed an association with MS. After logistic regression, depression (PR = 1.86; 95%CI: 1.38–2.51), acanthosis (PR = 1.50; 95%CI: 1.18–1.90), use of antipsychotics (PR = 1.88; 95%CI: 1.13–2.75), and hypertriglyceridemic waist (PR = 3.33; 95%CI: 2.48–4.46) were associated with MS. Conclusion: The prevalence of MS signals multimorbidity among individuals with mental disorders and suggests a need for clinical screening.
To analyze the accuracy of clinical indicators of constipation in cancer patients undergoing chemotherapy.
A diagnostic accuracy study was conducted from February to September 2018, with 240 cancer ...patients undergoing chemotherapy. The data collection instrument was a form with sociodemographic and clinical variables, and clinical indicators of constipation. The sensitivity and specificity of the clinical indicators of interest were calculated using a latent class analysis approach.
The prevalence of constipation in the sample was 86.6%. The most sensitive clinical indicators were straining with defecation (100.0%), and hypoactive bowel sounds (75.0%), while headache (99.9%), abdominal pain (75.0%), pain with defecation (75.0%), straining with defecation (99.9%) and liquid stool (78.1%) were indicators with high specificity.
A set of six clinical indicators was significantly associated with the occurrence of constipation in cancer patients undergoing chemotherapy, especially straining with defecation. These indicators can be used by nurses to identify constipation and propose prompt and effective interventions.
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