关键词： Sex differences   Sexual selection   Disease risk   Brain development   Cognition  

摘要： Sex-specific brain and cognitive deficits emerge with malnutrition, some infectious and neurodegenerative diseases, and often with prenatal or postnatal toxin exposure. These deficits are described in disparate literatures and are generally not linked to one another. Sexual selection may provide a unifying framework that integrates our understanding of these deficits and provides direction for future studies of sex-specific vulnerabilities. Sexually selected traits are those that have evolved to facilitate competition for reproductive resources or that influence mate choices, and are often larger and more complex than other traits. Critically, malnutrition, disease, chronic social stress, and exposure to man-made toxins compromise the development and expression of sexually selected traits more strongly than that of other traits. The fundamental mechanism underlying vulnerability might be the efficiency of mitochondrial energy capture and control of oxidative stress that in turn links these traits to current advances in neuroenergetics, stress endocrinology, and toxicology. The key idea is that the elaboration of these cognitive abilities, with more underlying gray matter or more extensive inter-modular white matter connections, makes them particularly sensitive to disruptions in mitochondria] functioning and oxidative stress. A framework of human sexually selected cognitive abilities and underlying brain systems is proposed and used to organize what is currently known about sex-specific vulnerabilities.

摘要： Population incidence is therefore an important predictor of individual risk and is widely used to examine the association between a disease and suspected risk factors, as well as the effectiveness of disease prevention measures such as vaccination to prevent meningitis3 or treatment of hypertension and atrial fibrillation to decrease stroke.4 Prevalence depends both on how quickly new cases of a disease arise and how long affected people ***-adjusted life-years (DALYs) is a composite measure of the overall disease burden expressed as the number of years lost to ill health, disability, and early death.2 In 2016, neurological disorders were ranked as the leading cause of DALYs and the second-leading cause of deaths globally.1 The validity and thereby the usefulness of estimates in the GBD project depend on many factors.5 Factors relevant for neurological diseases include completeness and validity of neurological case identification, which in turn depend on access to health care, diagnostic criteria, temporal changes in diagnostic criteria, and data quality of underlying data *** prevalence of neurological disorders will increase in the coming decades, because of the growth and ageing of the world *** few neurological diseases can be cured, preventive efforts need to be improved.

关键词： patient-provider communication   patient satisfaction  

摘要： Background: There has been increasing focus on both patient-reported outcome measurement (PROM) collection and patient satisfaction ratings;nevertheless, little is known about their relationship. Objectives: To determine the association between patient experience with PROM collection and visit satisfaction and to identify characteristics of better ratings for each. Methods: This cross-sectional observational study included all patients seen in 15 neurological clinics who completed PROMs as well as 6 questions on the patient experience with PROMs at least once from October 1, 2015 to December 31, 2016. Visit satisfaction was evaluated using a composite measure of physician communication, overall physician rating, and the likelihood of recommending that physician as indicated on the Clinician and Group Consumer Assessment of Healthcare Providers and Systems survey. Predictors of PROM experience and satisfaction were identified using proportional odds and logistic regression models, respectively. Results: There were 6454 patients (average age 58 +/- 15 years, 59% women) who completed PROMs and responded to the Clinician and Group Consumer Assessment of Healthcare Providers and Systems survey. There were significant positive associations between each PROM experience question and visit satisfaction (r = 0.11-0.19;P<.010), although factors predicting visit satisfaction differed from those predicting PROM experience. A differential effect of PROMs on visit satisfaction was identified for patients who were nonwhite, had lower income, and had more comorbidities. Conclusions: Although there was a significant association between better PROM experience and higher visit satisfaction, relationships with clinical characteristics differed, providing insights into how PROMs may be associated with patients' visit satisfaction. Further research is necessary to confirm whether PROMs can be used to improve visit satisfaction, particularly in patients who historically have reported lower

关键词： Autism   Instrumental delivery   Pediatric morbidity   Pregnancy outcomes  

摘要： Background: Concern exists regarding a possible harmful impact of vacuum extraction on the preterm newborn. We aimed to evaluate the long-term pediatric neurodevelopmental outcomes of the preterm offspring after vacuum extraction. Methods: A population-based cohort analysis was performed comparing the risk for long-term neurological morbidity (up to age 18 years) in preterm (less than 37 completed weeks of gestation) children born via following three delivery modes: vacuum extraction, spontaneous delivery, and Caesarean delivery performed during the second stage of labor. A Kaplan-Meier survival curve was used to compare the cumulative neurological morbidity in all groups. A Cox proportional hazards model was used to control for confounders. Results: During the study period 11,662 preterm newborns met the inclusion criteria, 97.2% (n = 11,338) of which were born via spontaneous vaginal delivery, 2.3% (n = 267) underwent vacuum extraction, and 0.5% (n = 57) were delivered by Caesarean section during the second stage of labor. Gestational age at delivery median (range) was 36 (29 to 36) weeks for vacuum extractions, 36 (23 to 36) for spontaneous vaginal delivery, and 35 (29 to 36) for Caesarean delivery within second stage of labor. Total pediatric hospitalizations involving neurological diagnoses were comparable between the groups as were the cumulative incidences of total neurological morbidity in the survival curves (log rank P = 0.723). In the Cox regression model, vacuum delivery in preterm newborns was not found to be associated with later pediatric neurological hospitalizations. Conclusions: Vacuum extraction performed on preterm newborns does not appear to be independently associated with severe long-term neurological morbidity, as reflected by later pediatric hospitalizations. (C) 2018 Elsevier Inc. All rights reserved.

摘要： Background Bullous pemphigoid (BP) is the most common subepidermal autoimmune blistering disease with an increased incidence particularly among the elderly. Several studies have recently reported an association between BP and neurological disorders. Objective To evaluate the association between BP and neurological disorders in a single centre in Germany. Methods We retrospectively assessed 183 patients with BP (diagnosed between 2011 and 2015) and 348 age-and sex-matched controls for neurological disorders. The latter were confirmed either by a neurologist or psychiatrist. Results Overall, there was a highly statistically significant association between BP and neurological disorders (P < 0.0001). These included dementia (P < 0.0001), Parkinson's disease (P = 0.0434), stroke (P = 0.0015) and other neurological disorders but not Alzheimer's diseases, which was more common among patients in the control group. Conclusion Our cohort of bullous pemphigoid and neurological disorders demonstrates a significant association between bullous pemphigoid and neurological disorders, including dementia, Parkinson's disease and stroke. These observations support the need for future studies in order to elucidate the immunological mechanisms responsible for these comorbidities.

关键词： Aging   Traumatic brain injury   Neuroinflammation   Microglia   Behavior  

摘要： After traumatic brain injury (TBI), individuals aged over 65 years show increased mortality and worse functional outcomes compared with younger persons. As neuroinflammation is a key pathobiological mechanism of secondary injury after TBI, we examined how aging affects post-traumatic microglial responses and functional outcomes. Young (3-month-old) and aged (18-month-old) male C57BL/6 mice were subjected to moderate-level controlled cortical impact or sham surgery, and neurological function was evaluated. At 72 hours after injury, brain, blood, and spleen leukocyte counts were assessed ex vivo using flow cytometry. Aged mice demonstrated more severe deficits in forelimb grip strength, balance and motor coordination, spontaneous locomotor activity, and anxiety-like behavior. These animals also exhibited more robust microglial proliferation and significantly higher numbers of brain-infiltrating leukocytes. Microglia in aged mice showed impairments in phagocytic activity and higher production of interleukin-1 beta (IL-1 beta). Infiltrating myeloid cells in aged TBI mice also had deficits in phagocytosis but showed diminished proinflammatory cytokine production and greater reactive oxygen species production. Expression of several senescence markers (Bcl-2, p16(ink4a), p21(cip1a), lipofuscin, and H2AX [pS139]) was increased with age and/or TBI in both microglia and injured cortex. Although there was no difference in the number of circulating blood neutrophils as a function of age, young mice exhibited more pronounced TBI-induced splenomegaly and splenic myeloid cell expansion. Thus, worse post-traumatic behavioral outcomes in aged animals are associated with exaggerated microglial responses, increased leukocyte invasion, and upregulation of senescence markers. (C) 2019 Elsevier Inc. All rights reserved.

摘要： Background & Aim Cell therapy-based regenerative medicine provides a powerful tool against diseases that have been intractable to treat with conventional medicine. Employing genome-editing strategies, we addressed the safety concerns associated with cell-based regenerative medicine through the development of the FailSafe (FS) Cell System. This proprietary technology inserts a suicide gene into a cell division essential locus, allowing selective elimination of proliferative cells through the administration of a pro-drug, whilst also protecting the suicide gene from inactivation. When incorporated into mouse embryonic stem cells (mESCs) and injected subcutaneously, the Fail-Safe system allows the proliferating component of a teratoma to be eliminated by brief treatment with the pro-drug for the suicide gene. The remaining non-proliferating component is induced into a stable and dormant ectopic tissue. To enable the development of economically feasible “off-the-shelf” cell products, we identified a set of eight immune-modulating genes involved in allograft tolerance and rejection. When expressed in FailSafe mESCs, the immune-cloaking system is sufficient to prevent rejection of ectopic tissues in immune-competent major histocompatibility complex-mismatched recipient mice. In the current study we sought to demonstrate the application of our technology for treatment of neurological ***, Results & Conclusion By incorporating expression of enhanced firefly luciferase, we used bioluminescence imaging (BLI) to monitor the survival and proliferation of gene-edited mESCs after stereotaxic injection into the mouse brain. Small numbers (1 × 10⁴) of mESCs injected into the lateral ventricles were detectable by BLI. Weekly monitoring of live animals revealed that the BL signal increased over time, indicative of the proliferation of injected cells. Histological examination of brain tissue confirmed that mESCs formed teratomas containing structures derived fr

摘要： Highlights from the article: Functional neurological symptom disorder (FNSD) is common and describes neurological symptoms not consistent with other established neurological diseases [[1]]. As one-third of patients with classical neurological diseases have comorbid psychic symptoms, we have included psychotherapeutic treatment in our inpatient neurological rehabilitation treatment program for many years [[13]]. We want to sensitize all neurological rehabilitation patients to functional symptoms as there is some overlap (e.g., Multiple Sclerosis or epilepsy with additional functional symptoms) [[14]]. On the other hand, there is an urge to evaluate integrated inpatient treatment for FNSD patients, e.g. psychosocial participation through The Work and Social Adjustment Scale [[19]] as well as functional symptoms [[20]], ideally complemented through expert rating [[22]].

摘要： The article offers information on the placental abruption and neurological disorders in children. Topics discussed include placenta is considered a treasure trove that stores a wealth of information on the woman, her fetus, and the pregnancy; mentions there is a growing evidence for shared risk factors for abruption and neurodevelopmental disorders; and also mentions inflammation and infection are also implicated in preterm delivery.