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Objective: This observational study examined the relationship between presurgical white matter microstructural coherence and cognitive change after weight loss. It was hypothesized that higher baseline fractional anisotropy (FA) would predict greater baseline and change cognition. Methods: A sample of 24 adults (BMI ≥ 35 kg/m2) underwent neuropsychological assessment at baseline and 12 weeks after bariatric surgery. A magnetic resonance imaging brain scan was administered at baseline and processed through Tract‐Based Spatial Statistics to compute FA in white matter tracts of interest. Composite scores for attention, learning, processing speed, executive function, verbal fluency, working memory, and overall cognition were calculated. Results: As expected, FA in some tracts of interest was significantly (p < 0.05) positively associated with change in cognition. Inverse relationships were observed between baseline FA and presurgical cognition, which may be explained by increased medial and radial diffusivity and preserved axonal diffusivity. Cognition generally improved after surgery; however, relative but clinically nonsignificant deterioration was observed on learning measures. Poorer baseline cognitive performance was associated with greater postsurgical cognitive improvement. Conclusions: Presurgical microstructural coherence is associated with magnitude of cognitive change after weight loss. An observed reduction in learning suggests that bariatric surgery may lead to negative outcomes in some cognitive domains, at least temporarily. [ABSTRACT FROM AUTHOR]

This study aimed to synthesize existing research on the effects of sleep disturbances on trauma‐focused psychotherapy outcomes in adults with posttraumatic stress disorder (PTSD). A systematic review using PubMed, PsycINFO, Embase, Web of Science, and PTSDpubs was performed up to April 2021. Two independent reviewers screened articles for inclusion, performed data extraction, and assessed risk of bias and certainty of the evidence. Narrative synthesis was conducted based on the type of sleep disorder symptom assessed. Sixteen primary studies were included in this review, the majority of which had a high overall risk of bias. Results suggested that sleep disorder symptoms were associated with higher overall PTSD severity across treatment; however, they did not interfere with treatment effectiveness, with the exception of sleep‐disordered breathing. Improvements in insomnia, sleep duration, and sleep quality during treatment were associated with greater treatment gains. Certainty of the evidence ranged from low to very low. These results suggest that it may not be necessary to address sleep disorder symptoms prior to initiating trauma‐focused psychotherapy. Instead, concurrent treatment of sleep‐ and trauma‐related symptoms may be most beneficial. Continued research is needed to clarify the mechanistic relationship between sleep and treatment outcomes and to guide clinical decision‐making. [ABSTRACT FROM AUTHOR]

Obesity is associated with adverse effects on brain health, including an increased risk of neurodegenerative diseases. Changes in cerebral metabolism may underlie or precede structural and functional brain changes. While bariatric surgery is known to be effective in inducing weight loss and improving obesity‐related medical comorbidities, few studies have examined whether it may be able to improve brain metabolism. In the present study, we examined changes in cerebral metabolite concentrations in participants with obesity who underwent bariatric surgery. Thirty‐five patients with obesity (body mass index ≥ 35 kg/m2) were recruited from a bariatric surgery candidate nutrition class. They completed single voxel proton magnetic resonance spectroscopy at baseline (presurgery) and within 1 year postsurgery. Spectra were obtained from a large medial frontal brain region using a PRESS sequence on a 3‐T Siemens Verio scanner. The acquisition parameters were TR = 3000 ms and TE = 37 ms. Tissue‐corrected metabolite concentrations were determined using Osprey. Paired t‐tests were used to examine within‐subject change in metabolite concentrations, and correlations were used to relate these changes to other health‐related outcomes, including weight loss and glycated hemoglobin (HbA1c), a measure of blood sugar levels. Bariatric surgery was associated with a reduction in cerebral choline‐containing compounds (Cho; t [34] = − 3.79, p < 0.001, d = −0.64) and myo‐inositol (mI; t [34] = − 2.81, p < 0.01, d = −0.47) concentrations. There were no significant changes in N‐acetyl‐aspartate, creatine, or glutamate and glutamine concentrations. Reductions in Cho were associated with greater weight loss (r = 0.40, p < 0.05), and reductions in mI were associated with greater reductions in HbA1c (r = 0.44, p < 0.05). In conclusion, participants who underwent bariatric surgery exhibited reductions in cerebral Cho and mI concentrations, which were associated with improvements in weight loss and glycemic control. Given that elevated levels of Cho and mI have been implicated in neuroinflammation, reduction in these metabolites after bariatric surgery may reflect amelioration of obesity‐related neuroinflammatory processes. As such, our results provide evidence that bariatric surgery may improve brain health and metabolism in individuals with obesity. [ABSTRACT FROM AUTHOR]

Background: Rapid declines in processing speed performance occur in aging and serve as a critical marker of cognitive abilities. Studies suggest that Useful Field of View (UFOV) training may ameliorate cognitive decline. The ACTIVE trial, consisting of over 2,800 participants, found a 29% reduction in ADRD risk 10 years following intervention. Recent clinical trials aimed at slowing cognitive decline in AD have focused on UFOV‐based interventions. Despite its efficacy, little is known about its neural correlates. The current study investigated blood‐oxygen level dependent (BOLD) activation patterns of the UFOV task. Method: 233 older adults completed the UFOV task while undergoing task‐based fMRI. The UFOV task requires participants to identify a central target, as well as a peripheral target amongst distractors, presented for a brief period of time. First‐level contrasts modeled hemodynamic response, while second‐level analyses assessed unique BOLD activation associated with encoding and recall components of the task. Age, education, sex and scanner were included as covariates. Significant clusters were defined as >10 voxels, and all clusters were corrected at a false discovery rate (FDR) of p<0.05. Result: Previous data have shown widespread bilateral whole‐brain activation associated with the encoding component, whereas discrete activation patterns were related to the recall component of the task. Additionally, numerous shared brain regions were critical to both the encoding and recall components of the UFOV task. We further investigated cortical activation patterns associated with age‐related differences in UFOV performance. Variability in performance was related to widespread patterns of activation during the encoding component of the UFOV task, namely the superior parietal lobule, insula, hippocampus and DLPFC. Assessing UFOV performance variability within recall, no significant clusters survived FDR correction. Furthermore, the inferior parietal lobule, cerebellum, and inferior frontal gyrus were critical in both encoding and recall in UFOV performance. Conclusion: The present study elucidates pivotal regions associated with UFOV task performance. Notably, we found that variability in UFOV performance is directly associated with neural activation during the presentation/apprehension of the stimuli, but not during recall. These findings suggest that variation in neural activation during speeded attentional processing is central to age‐related UFOV performance differences, and interventions targeting these neural processes may be of benefit. [ABSTRACT FROM AUTHOR]

Aerosols are an important component of the climate system affecting visibility, clouds, and climate. They are also transported over short and long distances with consequences for continental‐scale nutrient availability. Processes that remove aerosols from the atmosphere are difficult to evaluate with observations in isolation from aerosol sources. As a result, a quantitative assessment of uncertainties in our understanding of aerosols is limited and narrowing of those uncertainties is difficult to demonstrate. In this study, we use satellite observations of sulfur dioxide (SO2) and aerosols downwind of the Kīlauea volcano during May–September 2008. We derive the SO2 emission rate, the loss rate of SO2 that is indicative of the production rate of sulfate aerosols, and the subsequent removal rate of the formed sulfate. The result is the first determination of volcanic sulfate aerosol lifetime, 40–64 h, directly from satellite observations. The derived sulfate lifetime is significantly lower than the global average (3–5.5 days) and reflects the rapid wet scavenging of this plume. Key Points: We present the first direct inference of aerosol lifetime from satellite observations downwind of the Kīlauea volcanoThe derived sulfate lifetime of 40–64 h reflects the rapid wet scavenging above cloud [ABSTRACT FROM AUTHOR]

Alcohol use disorder (AUD) among people living with HIV (PLWH) is a significant public health concern. Despite the advent of effective antiretroviral therapy, up to 50% of PLWH still experience worsened neurocognition, which comorbid AUD exacerbates. We report converging lines of neuroimaging and neuropsychological evidence linking comorbid HIV/AUD to dysfunction in brain regions linked to executive function, learning and memory, processing speed, and motor control, and consequently to impairment in daily life. The brain shrinkage, functional network alterations, and brain metabolite disruption seen in individuals with HIV/AUD have been attributed to several interacting pathways: viral proteins and EtOH are directly neurotoxic and exacerbate each other's neurotoxic effects; EtOH reduces antiretroviral adherence and increases viral replication; AUD and HIV both increase gut microbial translocation, promoting systemic inflammation and HIV transport into the brain by immune cells; and HIV may compound alcohol's damaging effects on the liver, further increasing inflammation. We additionally review the neurocognitive effects of aging, Hepatitis C coinfection, obesity, and cardiovascular disease, tobacco use, and nutritional deficiencies, all of which have been shown to compound cognitive changes in HIV, AUD, and in their comorbidity. Finally, we examine emerging questions in HIV/AUD research, including genetic and cognitive protective factors, the role of binge drinking in HIV/AUD‐linked cognitive decline, and whether neurocognitive and brain functions normalize after drinking cessation. [ABSTRACT FROM AUTHOR]

Governments restricted mobility and effectively shuttered much of the global economy in response to the COVID‐19 pandemic. Six San Francisco Bay Area counties were the first region in the United States to issue a "shelter‐in‐place" order asking non‐essential workers to stay home. Here we use CO2 observations from 35 Berkeley Environment, Air‐quality and CO2 Network (BEACO2N) nodes and an atmospheric transport model to quantify changes in urban CO2 emissions due to the order. We infer hourly emissions at 900‐m spatial resolution for 6 weeks before and 6 weeks during the order. We observe a 30% decrease in anthropogenic CO2 emissions during the order and show that this decrease is primarily due to changes in traffic (–48%) with pronounced changes to daily and weekly cycles; non‐traffic emissions show small changes (–8%). These findings provide a glimpse into a future with reduced CO2 emissions through electrification of vehicles. Plain Language Summary: This work uses atmospheric observations to quantify the changes in urban CO2 emissions from different sectors in response to COVID‐19 mobility regulations. Key Points: A 30% decrease in urban CO2 emissions was observed from the San Francisco Bay Area in response to COVID‐19 mobility restrictionsChanges are primarily driven by a decrease in CO2 emissions from traffic (–48%)There is a large change to the weekly and diurnal cycle of emissions with reductions in morning rush hour emissions [ABSTRACT FROM AUTHOR]

BACKGROUND AND PURPOSE: Cardiovascular disease (CVD) encompasses a range of disorders that affect health and functioning in older adults. While cognitive declines have been linked to both cardiovascular and cerebral blood perfusion, protective neurovascular mechanisms raise the question whether cerebrovascular perfusion differs as a function of cardiovascular health status. The present study examined whether cerebrovascular perfusion significantly differs between healthy older adults with and without diagnosed CVD. The study also examined whether previously documented sex differences in cerebral perfusion would be replicated. METHODS: Twenty CVD patients without significant heart failure and 39 healthy controls were recruited to undergo a comprehensive assessment, including an interview, echocardiogram, and magnetic resonance imaging). Arterial spin labeling was used to quantify cerebral blood perfusion. RESULTS: Both groups exhibited mean left ventricular ejection fractions that fell within normal limits. In line with previous research, women exhibited significantly higher cerebral perfusion than men. There were no significant group differences in whole brain cerebrovascular perfusion, regional perfusion, or white matter perfusion by patient status after accounting for sex and age. CONCLUSIONS: These findings suggest that the effects of mild CVD on cerebrovascular perfusion are minimal. Future studies are needed to investigate the mechanisms involved in maintaining cerebrovascular perfusion in the context of altered peripheral perfusion and to determine whether this finding extends to more acute or severe CVD. [ABSTRACT FROM AUTHOR]

Organic nitrates (RONO2) are an important NOx sink. In warm, rural environments dominated by biogenic emissions, nocturnal NO3‐initiated production of RONO2 is competitive with daytime OH‐initiated RONO2 production. However, in urban areas, OH‐initiated production of RONO2 has been assumed dominant and NO3‐initiated production considered negligible. We show evidence for nighttime RONO2 production similar in magnitude to daytime production during three aircraft campaigns in chemically distinct summertime environments: Studies of Emissions and Atmospheric Composition, Clouds, and Climate Coupling by Regional Surveys (SEAC4RS) in the rural Southeastern United States, Front Range Air Pollution and Photochemistry Experiment (FRAPPÉ) in the Colorado Front Range, and Korea‐United States Air Quality Study (KORUS‐AQ) around the megacity of Seoul. During each campaign, morning observations show RONO2 enhancements at constant, near‐background Ox (≡ O3+NO2) concentrations, indicating that the RONO2 are from a non‐photochemical source, whereas afternoon observations show a strong correlation between RONO2 and Ox resulting from photochemical production. We show that there are sufficient precursors for nighttime RONO2 formation during all three campaigns. This evidence impacts our understanding of nighttime NOx chemistry. Plain Language Summary: Nitrogen oxides are pollutants emitted during combustion which are involved in ozone and secondary aerosol production. One way in which nitrogen oxides are removed from the atmosphere is via chemistry that converts them to organic nitrates. This conversion of nitrogen oxides to organic nitrates has been thought to occur primarily during the day when the chemistry is driven by sunlight. Here we show evidence that nighttime processes generate similar quantities of organic nitrates to those produced by sunlight‐driven processes. Key Points: We show evidence for nocturnal production of organic nitrates similar in magnitude to daytime photochemical productionSignificant nocturnal production of organic nitrates observed from three aircraft campaigns in distinct environmentsNighttime production of organic nitrates impacts our understanding of the nighttime lifetime and fate of NOx [ABSTRACT FROM AUTHOR]

Lightning is a large and variable source of nitrogen oxides (NOx ≡ NO + NO2) to the upper troposphere. Precise estimates of lightning NOx (LNOx) production rates are needed to constrain tropospheric oxidation chemistry; however, controls over LNOx variability are poorly understood. Here, we describe an observational analysis of variability in LNO2 with lightning type by exploiting U.S. regional differences in lightning characteristics in the Southeast, South Central, and North Central United States. We use satellite NO2 measurements from the Ozone Monitoring Instrument with Berkeley High Resolution vertical column densities, a combined lightning data set derived from the Earth Networks Total Lightning Network and National Lightning Detection NetworkTM measurements, and hourly winds from the European Centre for Medium‐Range Weather Forecasts climate reanalysis data set (ERA5) over May–August 2014–2015. We find evidence that cloud‐to‐ground (CG) strokes produce a factor of 9–11 more NO2 than intracloud (IC) strokes for storms with stroke rates of at least 2,800 strokes·cell−1·hr−1. We show that regional differences in LNO2 production rates are generally consistent with regional patterns CG and IC stroke frequency and stroke current density. A comparison of stroke‐based and flash‐based CG/IC LNO2 estimates suggests that CG LNO2 is potentially underestimated when derived with flash data due to the operational definition of CG lightning. We find that differences in peak current explain a large portion of CG/IC LNO2 variability, but that other factors must also be important, including minimum stroke rate. Because IC and CG strokes produce NOx in distinct areas of the atmosphere, we test the sensitivity of our results against the atmospheric NO2 vertical distribution assumed in the a priori profiles; we show that the relative CG to IC LNO2 was generally insensitive to the assumed NO2 vertical distribution. Key Points: Lightning NO2 production rates in the United States vary with regional differences in average current per strokeCloud‐to‐ground (CG) strokes produce more LNO2 than intracloud (IC) strokes in the United StatesLNO2 derived from flash rather than stroke data may obscure CG and IC NO2 production per stroke differences [ABSTRACT FROM AUTHOR]

Background: The number of men undergoing prostate biopsy and subsequent cancer detection rates has changed significantly over the past 15 years. We aim to evaluate changes in the diagnostic pathway of prostate cancer between 2003 and 2018. Methods: A total of 13 844 Western Australian biopsy‐naive men were assessed to determine trends in age, prostate‐specific antigen levels, number of core samples, positive cores and tumour grade (Gleason) between 2003 and 2018. Further, in 2018, the impact of pre‐biopsy multiparametric magnetic resonance imaging (mpMRI) was also assessed. Results: Between 2003 and 2012, the number of men undergoing biopsy increased from 1445 to 3100. During this time, the prostate cancer detection rate (%) remained unchanged. However, in 2018, 2042 men underwent prostate biopsy (reduction of 34.1%) and the detection rate increased to 72.6%. The incidence of low‐grade cancer (Gleason score <7) increased from 28.1% in 2003 to 36.2% in 2012, but it decreased significantly to 15.1% by 2018. High‐grade cancer (Gleason score >7) declined from 21.3% in 2003 to 15.2% in 2012 but then increased to 35.7% in 2018. The use of mpMRI in 2018 improved the detection rate of high‐grade cancer. However, its specificity remains low (29.7%) and a considerable proportion of low Prostate Imaging Reporting and Data System score lesions was later diagnosed with cancer unsuitable for active surveillance. Conclusion: In recent years, there has been a significant increase in the diagnosis high‐grade cancer and a reduction in cancer suitable for active surveillance. mpMRI identifies high‐grade tumours but is not a reliable alternative to prostate biopsy. [ABSTRACT FROM AUTHOR]

During September–October 2016, a marine aerosol generator configured with forced‐air Venturis was deployed at two biologically productive and two oligotrophic regions of the western North Atlantic Ocean to investigate factors that modulate primary marine aerosol (PMA) production. The generator produced representative bubble size distributions with Hinze scales (0.32 to 0.95 mm radii) and void fractions (0.011 to 0.019 Lair Lsw‐1) that overlapped those of plumes produced in the surface ocean by breaking wind waves. Hinze scales and void fractions of bubble plumes varied among seawater hydrographic regions, whereas corresponding peaks and widths of bubble size distributions did not, suggesting that variability in seawater surfactants drove variability in plume dynamics. Peaks in size‐resolved number production efficiencies for model PMA (mPMA) emitted via bubble bursting in the generator were within a narrow range (0.059 to 0.069 μm geometric mean diameter) over wide ranges in subsurface bubble characteristics, suggesting that subsurface bubble size distributions were not the primary controlling factors as was suggested by previous work. Total mass production efficiencies for mPMA decreased with increasing air detrainment rates, supporting the hypothesis that surface bubble rafts attenuate mPMA mass production. Total mass and Na+ production efficiencies for mPMA from biologically productive seawater were significantly greater than those from oligotrophic seawater. Corresponding mPMA number distributions peaked at smaller sizes during daytime, suggesting that short‐lived surfactants of biological and/or photochemical origin modulated diel variability in marine aerosol production. Key Points: Aerosol mass production efficiencies decreased with increasing rates of bubble air detrainment in seawaterProduction efficiencies and enrichment factors of particulate organic mass were higher for productive relative to oligotrophic seawaterAerosol number production efficiencies were insensitive to relative variability in subsurface bubble size distributions [ABSTRACT FROM AUTHOR]

We present a comparison of instruments measuring nitrogen oxide species from an aircraft during the 2015 Wintertime INvestigation of Transport, Emissions, and Reactivity (WINTER) campaign over the northeast United States. Instrument techniques compared here include chemiluminescence (CL), thermal dissociation laser‐induced fluorescence (TD‐LIF), cavity ring‐down spectroscopy (CRDS), high‐resolution time of flight, iodide‐adduct chemical ionization mass spectrometry (I‐CIMS), and aerosol mass spectrometry. Species investigated include NO2, NO, total nitrogen oxides (NOy), N2O5, ClNO2, and HNO3. Particulate‐phase nitrate is also included for comparisons of HNO3 and NOy. Instruments generally agreed within reported uncertainties, with individual flights sometimes showing much better agreement than the data set taken as a whole, due to flight‐to‐flight slope changes. NO measured by CRDS and CL showed an average relative slope of 1.16 ± 0.01 across all flights, which is outside of combined uncertainties. The source of the error was not identified. For NO2 measured by CRDS and TD‐LIF the average was 1.02 ± 0.00; for NOy measured by CRDS and CL the average was 1.01 ± 0.00; and for N2O5 measured by CRDS and I‐CIMS the average was 0.89 ± 0.01. NOy budget closure to within 20% is demonstrated. We observe nonlinearity in NO2 and NOy correlations at concentrations above ~30 ppbv that may be related to the NO discrepancy noted above. For ClNO2 there were significant differences between I‐CIMS and TD‐LIF, potentially due in part to the temperature used for thermal dissociation. Although the fraction of particulate nitrate measured by the TD‐LIF is not well characterized, it improves comparisons to include particulate measurements. Key Points: Nitrogen oxides are accurately and precisely measured by a number of independent methodsNew chemical ionization approaches compare well with more established methodsClosure of the NOy budget was observed [ABSTRACT FROM AUTHOR]

Objective: This study examined the relationship between specific metabolic and vascular risk factors and cognition in adults with severe obesity.Methods: A total of 129 adults (with BMI ≥ 35 kg/m2 ) underwent a baseline clinical evaluation and neuropsychological assessment. Regression analyses examined the relationship between cognition and medical factors (BMI, hemoglobin A1c, diabetes, hypertension, continuous positive airway pressure use, obstructive sleep apnea [OSA], and osteoarthritis).Results: Diabetes was associated with deficits in overall cognitive performance and with deficits in the executive processing speed and verbal fluency domains. Hemoglobin A1c was inversely related to overall cognitive performance and deficits in the attention domain. Participants using continuous positive airway pressure to treat OSA had stronger learning and memory performance, whereas OSA was associated with reduced total learning. Elevated BMI together with diabetes diagnosis was associated with reduced verbal fluency and greater variability in sustained attention.Conclusions: Obesity-associated comorbidities most notably appeared to have a greater relative influence on cognitive performance than BMI itself in adults with severe obesity. This likely reflects the fact that a very elevated BMI was ubiquitous and thereby probably exerted a similar influence among all adults in the cohort. Accordingly, in the context of severe obesity, diabetes and other comorbidities may have greater sensitivity to cognitive deficits than BMI alone. [ABSTRACT FROM AUTHOR]

Background: Human immunodeficiency virus (HIV) infection and heavy drinking independently promote microbial translocation and inflammation. However, it is not known how alcohol use may affect these processes in people living with HIV (PLWH). This study tested the hypothesis that alcohol exacerbates innate immune dysfunction in PLWH. Methods: Participants were 75 PLWH and 34 uninfected controls. Groups were recruited to have similar proportions of nondrinkers, moderate drinkers, and heavy drinkers. Substance use data and plasma samples were collected at up to 3 visits over a 5‐year study period. Recent alcohol use was assessed with the Timeline Followback Interview. Biomarkers of microbial translocation (lipopolysaccharide, LPS) and immune activation (lipopolysaccharide binding protein, LBP; soluble CD14, sCD14; soluble CD163, sCD163) were quantified using enzyme‐linked immunosorbent assays. Analyses tested 2 hypotheses: (i) that biomarker levels would be significantly higher in PLWH than controls with comparable alcohol use and (ii) that current alcohol use would exacerbate biomarker elevations in PLWH. The second analysis included the interaction of alcohol use with hepatitis C virus (HCV) coinfection. Results: Groups were matched on alcohol use, smoking, and other drug use. All biomarkers were significantly higher in PLWH relative to controls (LBP: p = 0.005; LPS: p = 0.014; sCD14: p < 0.001; sCD163: p < 0.001). In PLWH, alcohol use showed a significant, positive association with sCD163, but not with other biomarkers. However, the interaction of alcohol use with HCV coinfection was significant for all biomarkers (LBP: p = 0.002; LPS: p = 0.026; sCD14: p = 0.0004; sCD163: p = 0.001). In pairwise tests with sequential Bonferroni correction, HIV/HCV coinfected individuals who drank heavily had significantly higher sCD163 compared to coinfected nondrinkers and to HIV monoinfected nondrinkers, moderate drinkers, and heavy drinkers (ps < 0.005). Coinfected moderate drinkers had significantly higher sCD163 than each monoinfected group (ps < 0.003). In addition, sCD14 was significantly higher in coinfected moderate drinkers than coinfected nondrinkers (p = 0.027). Conclusions: As predicted, PLWH had higher levels of LBP, LPS, sCD14, and sCD163 than uninfected individuals with similar alcohol use. In PLWH, alcohol by itself was significantly associated only with higher sCD163. However, heavy or moderate alcohol use was associated with elevations in macrophage activation (sCD163) and monocyte activation (sCD14) in HIV/HCV coinfected individuals. [ABSTRACT FROM AUTHOR]

Objective: Fatigue and cognitive dysfunction are major concerns for women with early-stage breast cancer during treatment and into survivorship. However, interrelationships of these phenomena and their temporal patterns over time are not well documented, thus limiting the strategies for symptom management interventions. In this study, changes in fatigue across treatment phases and the relationship among fatigue severity and its functional impact with objective cognitive performance were examined.Methods: Participants (N = 75) were assessed at five time points beginning prior to chemotherapy to 24 months after initial chemotherapy. Fatigue severity and impact were measured on the Brief Fatigue Inventory. Central nervous system (CNS) Vital Signs was used to measure performance based cognitive testing. Temporal changes in fatigue were examined, as well as the relationship between fatigue and cognitive performance, at each time point using linear mixed effect models.Results: Severity of fatigue varied as a function of phase of treatment. Fatigue severity and its functional impact were moderate at baseline, increased significantly during chemotherapy, and returned to near baseline levels by 2 years. At each time point, fatigue severity and impact were significantly associated with diminished processing speed and complex attention performance.Conclusions: A strong association between fatigue and objective cognitive performance suggests that they are likely functionally related. That cognitive deficits were evident at baseline, whereas fatigue was more chemotherapy dependent, implicates that two symptoms share some common bases but may differ in underlying mechanisms and severity over time. This knowledge provides a basis for introducing strategies for tailored symptom management that vary over time. [ABSTRACT FROM AUTHOR]

Background: There is growing concern about the health impact of heavy alcohol use in people infected with human immunodeficiency virus (HIV+). Mixed findings of past studies regarding the cognitive impact of alcohol use in HIV+ adults have been mixed, with inconsistent evidence that alcohol consumption exacerbates HIV‐associated brain dysfunction. This study examined contributions of current heavy drinking, lifetime alcohol use disorder (AUD), and age to cognitive deficits in HIV+ adults, and relative to other HIV‐associated clinical factors. Methods: Cognitive performance of HIV+ adults (n = 104) was assessed, and comparisons were made between heavy current to nonheavy drinkers (NIAAA criteria), lifetime AUD versus no‐AUD, and older (>50 years) versus younger participants. Hierarchical regression analyses were conducted to examine the association between cognitive performance and current heavy drinking, lifetime AUD, and older age, while also correcting for HIV clinical factors and history of other substance use. Results: Individuals reporting current heavy drinking and meeting criteria for lifetime AUD demonstrated the greatest degree of deficits across multiple cognitive domains. Deficits were greatest among HIV+ adults with lifetime AUD, and older age was also associated with weaker cognitive performance. Lifetime AUD and older age independently exhibited stronger associations with cognitive performance than HIV clinical factors (e.g., viral load, current CD4, and nadir CD4) or past opiate and cocaine use. Conclusions: Current heavy drinking and lifetime AUD adversely affect cognitive function in HIV+ adults. Greatest deficits existed when there was a history of AUD and continued current heavy drinking, indicating that past AUD continues to have an adverse impact and should not be ignored. That alcohol use was more strongly associated with cognitive performance than HIV clinical factors underscore clinical importance of targeting reduction in heavy alcohol consumption in HIV+ adults. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorder (AUD) is prevalent among individuals diagnosed with human immunodeficiency virus (HIV), and both HIV and alcohol use have been shown to negatively affect the integrity of white matter pathways in the brain. Behavioral, functional, and anatomical impairments have been linked independently to HIV and alcohol use, and these impairments have bases in specific frontally mediated pathways within the brain. Methods: Magnetic resonance imaging data were acquired for 37 HIV+ participants without dementia or hepatitis C. Imaging data were processed through the FreeSurfer and TraCULA pipelines to obtain 4 bilateral frontal white matter tracts for each participant. Diffusion metrics of white matter integrity along the highest probability pathway for each tract were analyzed with respect to demographics, disease‐specific variables, and reported substance use. Results: Significantly increased axial diffusivity (decreased axonal integrity) and a trending increase in mean diffusivity were observed along the anterior thalamic radiation (ATR) in participants with a history of AUD. A diagnosis of AUD explained over 36% of the variance in diffusivity along the ATR overall when accounting for clinical variables including nadir CD4 and age‐adjusted HIV infection length. Conclusions: This study provides evidence of HIV‐related associations between alcohol use and indicators of axonal integrity loss along the ATR, a frontal pathway involved in the inhibition of addictive or unwanted behaviors. Reduced axonal integrity of this pathway was greatest in HIV+ participants with an AUD, even when considering the effect of age‐adjusted disease length and severity (nadir CD4). This finding implicates a potential biological mechanism linking reduced integrity of frontal white matter to the high prevalence of AUD in an HIV+ population without dementia or hepatitis C. [ABSTRACT FROM AUTHOR]

Abstract: Better experimental models are needed to enhance our understanding of metabolic regulation which is seen in obesity and metabolic disorders, such as type 2 diabetes. In vitro models based on microfluidics enable physiological representations of tissues with several advantages over conventional culture systems, such as perfused flow to better mimic the physiological environment. Although cell lines such as 3T3‐L1 have been incorporated in microfluidic devices, murine primary preadipocytes have not been differentiated and maintained for long‐term monitoring in these culture systems. We describe the differentiation of these cells into white adipose depots on a perfused microfluidic chip. We compare the effects of shear flow on these cells, and show with a direct comparison of high/low shear conditions that direct shear is detrimental to the viability of preadipocytes. We further develop a dual‐chamber microfluidic chip that enables perfusion while at the same time protects the cells from direct fluidic shear. We show that the dual‐layer microfluidic device enables long‐term culture of cells and allows stimulation of cells through perfusion—we can culture, differentiate, and maintain the differentiated adipose tissue for over multiple weeks in the device. Both triglycerides and lipolytic glycerol production increased significantly by several folds during differentiation. After successful differentiation, the adipocytes had upregulated expression of leptin and adiponectin, which are important makers of the final stage of adipogenic differentiation. In conclusion, the dual‐layer microfluidic device incorporated with primary adipocytes improves the understanding of adipose differentiation under dynamic conditions and is positioned to serve as a disease model for studying obesity and other metabolic disorders. [ABSTRACT FROM AUTHOR]

Abstract: We describe the University of Washington airborne high‐resolution time‐of‐flight chemical ionization mass spectrometer (HRToF‐CIMS) and evaluate its performance aboard the NCAR‐NSF C‐130 aircraft during the recent Wintertime INvestigation of Transport, Emissions and Reactivity (WINTER) experiment in February–March of 2015. New features include (i) a computer‐controlled dynamic pinhole that maintains constant mass flow‐rate into the instrument independent of altitude changes to minimize variations in instrument response times; (ii) continuous addition of low flow‐rate humidified ultrahigh purity nitrogen to minimize the difference in water vapor pressure, hence instrument sensitivity, between ambient and background determinations; (iii) deployment of a calibration source continuously generating isotopically labeled dinitrogen pentoxide (15N2O5) for in‐flight delivery; and (iv) frequent instrument background determinations to account for memory effects resulting from the interaction between sticky compounds and instrument surface following encounters with concentrated air parcels. The resulting improvements to precision and accuracy, along with the simultaneous acquisition of these species and the full set of their isotopologues, allow for more reliable identification, source attribution, and budget accounting, for example, by speciating the individual constituents of nocturnal reactive nitrogen oxides (NOz = ClNO2 + 2 × N2O5 + HNO3 + etc.). We report on an expanded set of species quantified using iodide‐adduct ionization such as sulfur dioxide (SO2), hydrogen chloride (HCl), and other inorganic reactive halogen species including hypochlorous acid, nitryl chloride, chlorine, nitryl bromide, bromine, and bromine chloride (HOCl, ClNO2, Cl2, BrNO2, Br2, and BrCl, respectively). [ABSTRACT FROM AUTHOR]

Abstract: The San Joaquin Valley (SJV) of California experiences high concentrations of particulate matter NH4NO3 during episodes of meteorological stagnation in winter. A rich data set of observations related to NH4NO3 formation was acquired during multiple periods of elevated NH4NO3 during the Deriving Information on Surface Conditions from Column and Vertically Resolved Observations Relevant to Air Quality (DISCOVER‐AQ) field campaign in SJV in January and February 2013. Here NH4NO3 is simulated during the SJV DISCOVER‐AQ study period with the Community Multiscale Air Quality (CMAQ) model, diagnostic model evaluation is performed using the DISCOVER‐AQ data set, and integrated reaction rate analysis is used to quantify HNO3 production rates. Simulated NO3− generally agrees well with routine monitoring of 24‐hr average NO3−, but comparisons with hourly average NO3− measurements in Fresno revealed differences at higher time resolution. Predictions of gas‐particle partitioning of total nitrate (HNO3 + NO3−) and NHx (NH3 + NH4+) generally agree well with measurements in Fresno, although partitioning of total nitrate to HNO3 is sometimes overestimated at low relative humidity in afternoon. Gas‐particle partitioning results indicate that NH4NO3 formation is limited by HNO3 availability in both the model and ambient. NH3 mixing ratios are underestimated, particularly in areas with large agricultural activity, and additional work on the spatial allocation of NH3 emissions is warranted. During a period of elevated NH4NO3, the model predicted that the OH + NO2 pathway contributed 46% to total HNO3 production in SJV and the N2O5 heterogeneous hydrolysis pathway contributed 54%. The relative importance of the OH + NO2 pathway for HNO3 production is predicted to increase as NOx emissions decrease. [ABSTRACT FROM AUTHOR]

Abstract: Modeled source attribution information from the Community Multiscale Air Quality model was coupled with ambient data from the 2011 Deriving Information on Surface conditions from Column and Vertically Resolved Observations Relevant to Air Quality Baltimore field study. We assess source contributions and evaluate the utility of using aircraft measured CO and NOy relationships to constrain emission inventories. We derive ambient and modeled ΔCO:ΔNOy ratios that have previously been interpreted to represent CO:NOy ratios in emissions from local sources. Modeled and measured ΔCO:ΔNOy are similar; however, measured ΔCO:ΔNOy has much more daily variability than modeled values. Sector‐based tagging shows that regional transport, on‐road gasoline vehicles, and nonroad equipment are the major contributors to modeled CO mixing ratios in the Baltimore area. In addition to those sources, on‐road diesel vehicles, soil emissions, and power plants also contribute substantially to modeled NOy in the area. The sector mix is important because emitted CO:NOx ratios vary by several orders of magnitude among the emission sources. The model‐predicted gasoline/diesel split remains constant across all measurement locations in this study. Comparison of ΔCO:ΔNOy to emitted CO:NOy is challenged by ambient and modeled evidence that free tropospheric entrainment, and atmospheric processing elevates ambient ΔCO:ΔNOy above emitted ratios. Specifically, modeled ΔCO:ΔNOy from tagged mobile source emissions is enhanced 5–50% above the emitted ratios at times and locations of aircraft measurements. We also find a correlation between ambient formaldehyde concentrations and measured ΔCO:ΔNOy suggesting that secondary CO formation plays a role in these elevated ratios. This analysis suggests that ambient urban daytime ΔCO:ΔNOy values are not reflective of emitted ratios from individual sources. [ABSTRACT FROM AUTHOR]

Background: Effective non‐pharmacological interventions to remediate age‐related cognitive decline and alter trajectories toward dementia are limited. The Augmenting Cognitive Training in Older Adults trial (ACT) was the first phase III randomized clinical trial initiated for transcranial direct current stimulation. Method: This NIA funded trial sought to evaluate whether 3 months of cognitive training paired with bilateral 2mA tDCS to the frontal lobes could produce clinically meaningful improvement in a composite measure of cognitive function in healthy older adults: the NIH Toolbox Fluid Cognition Composite score. The ACT trial will be unblinded April 30, 2022. Further still, over the past 5 years, it has become increasingly evident that fixed dosing approaches to tDCS, like those used in the ACT and every other trial to date, are insufficient for addressing individual differences and maximizing clinical outcomes. Results: We will present, for the first time, the primary outcome results from the ACT trial. In addition, we will present initial findings from related secondary neuroimaging and cognitive indices. In this talk, we will also present preliminary findings from our ongoing work to refine dosing technology for tDCS in older adults using computational modeling, artificial intelligence and multimodal imaging, paired with tDCS outcomes from the ACT trial. Conclusion: We will present new analyses, available only upon unblinding of ACT. These data use person‐specific computational models of tDCS current flow paired with machine learning and clinical outcomes to identify critical characteristics of tDCS current in the brain (e.g., intensity, direction of current flow) most strongly associated with response vs. non‐response. These data will provide initial insight into which regions of the brain and what characteristics of current were strongly associated with treatment response in the ACT trial. In addition, these data also provide critical insight into how stimulation dosing (electrode positioning, stimulation intensity) can be modified at a person‐specific level to potentially enhance clinical outcomes. Thus, the proposed talk will provide state of the art trial findings from the first completed tDCS Phase III clinical trial paired with next generation approaches to remediated age‐related cognitive decline using tDCS technology. [ABSTRACT FROM AUTHOR]

Background: International estimates of the laparoscopic radical prostatectomy (LRP) learning curve extend to as many as 1000 cases, but is unknown for Fellowship‐trained Australian surgeons. Methods: Prospectively collected data from nine Australian surgeons who performed 2943 consecutive LRP cases was retrospectively reviewed. Their combined initial 100 cases (F100, n = 900) were compared to their second 100 cases (S100, n = 782) with two of nine surgeons completing fewer than 200 cases. Results: The mean age (61.1 versus 61.1 years) and prostate specific antigen (7.4 versus 7.8 ng/mL) were similar between F100 and S100. D'Amico's high‐, intermediate‐ and low‐risk cases were 15, 59 and 26% for the F100 versus 20, 59 and 21% for the S100, respectively. Blood transfusions (2.4 versus 0.8%), mean blood loss (413 versus 378 mL), mean operating time (193 versus 163 min) and length of stay (2.7 versus 2.4 days) were all lower in the S100. Histopathology was organ confined (pT2) in 76% of F100 and 71% of S100. Positive surgical margin (PSM) rate was 18.4% in F100 versus 17.5% in the S100 (P = 0.62). F100 and S100 PSM rates by pathological stage were similar with pT2 PSM 12.2 versus 9.5% (P = 0.13), pT3a PSM 34.8 versus 40.5% (P = 0.29) and pT3b PSM 52.9 versus 36.4% (P = 0.14). Conclusion: There was no significant improvement in PSM rate between F100 and S100 cases. Perioperative outcomes were acceptable in F100 and further improved with experience in S100. Mentoring can minimize the LRP learning curve, and it remains a valid minimally invasive surgical treatment for prostate cancer in Australia even in early practice. [ABSTRACT FROM AUTHOR]

Resting-state functional magnetic resonance image is a useful technique for investigating brain functional connectivity at rest. In this work, we develop flexible regression models and methods for determining differences in resting-state functional connectivity as a function of age, gender, drug intervention, or neuropsychiatric disorders. We propose two complementary methods for identifying changes of edges and subgraphs. (i) For detecting changes of edges, we select the optimal model at each edge and then conduct contrast tests to identify the effects of the important variables while controlling the familywise error rate. (ii) We adopt the network-based statistics method to improve power by incorporating the graph topological structure. Both methods have wide applications for low signal-to-noise ratio data. We propose stability criteria for the choice of threshold in the network-based statistics procedure and utilize efficient massive parallel procedure to speed up the estimation and inference procedure. Results from our simulation studies show that the thresholds chosen by the proposed stability criteria outperform the Bonferroni threshold. To demonstrate applicability, we use both methods in the context of the Oxytocin and Aging Study to determine effects of age, gender, and drug treatment on resting-state functional connectivity, as well as in the context of the Autism Brain Imaging Data Exchange Study to determine effects of autism spectrum disorder on functional connectivity at rest. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background The acute consumption of excessive quantities of alcohol causes well-recognized neurophysiological and cognitive alterations. As people reach advanced age, they are more prone to cognitive decline. To date, the interaction of current heavy alcohol (ethanol [ EtOH]) consumption and aging remains unclear. This study tested the hypothesis that negative consequences of current heavy alcohol consumption on neurocognitive function are worse with advanced age. Further, we evaluated the relations between lifetime history of alcohol dependence and neurocognitive function Methods Sixty-six participants underwent a comprehensive neurocognitive battery. Current heavy EtOH drinkers were classified using National Institute on Alcohol Abuse and Alcoholism criteria (EtOH heavy, n = 21) based on the Timeline follow-back and a structured clinical interview and compared to nondrinkers, and moderate drinkers (EtOH low, n = 45). Of the total population, 53.3% had a lifetime history of alcohol dependence. Neurocognitive data were grouped and analyzed relative to global and domain scores assessing: global cognitive function, attention/executive function, learning, memory, motor function, verbal function, and speed of processing. Results Heavy current EtOH consumption in older adults was associated with poorer global cognitive function, learning, memory, and motor function ( ps < 0.05). Furthermore, lifetime history of alcohol dependence was associated with poorer function in the same neurocognitive domains, in addition to the attention/executive domain, irrespective of age ( ps < 0.05). Conclusions These data suggest that while heavy current alcohol consumption is associated with significant impairment in a number of neurocognitive domains, history of alcohol dependence, even in the absence of heavy current alcohol use, is associated with lasting negative consequences for neurocognitive function. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the intermediate outcome of conservative management in patients with biopsy-proven oncocytoma. Patients and Methods Patients with oncocytoma diagnosed on percutaneous core biopsy between January 2000 to December 2014 were identified from the renal biopsy database of a large specialist urologic pathology laboratory. After review of patient clinical records, the study cohort comprised only of patients enrolled in active surveillance. Clinicopathological and follow-up details were reviewed for each case, in particular: type and interval of surveillance imaging, tumour growth, definitive intervention and reason for intervention. Where possible, correlation was made between the final surgical and the initial biopsy specimens. Results Fifty three patients diagnosed with oncocytoma on core biopsy were initially placed on active surveillance with median follow-up of 34 months (range 6-109). The median age at diagnosis was 65 years (range 20-85) and median tumour size was 30 mm (range 13-87). Mean average tumour growth was 1.4 mm per annum (median 0 mm/year) with the majority (36 of 53, 68%) exhibiting minimal growth (less than 2 mm per annum) or partial regression. Forty seven of the 53 patients remained on active surveillance with no significant progression. Six patients elected to undergo definitive intervention (five surgical excision, one ablation). Renal oncocytoma was confirmed in all five patients who underwent surgical excision of their lesions. Conclusions The majority of oncocytomas in this study showed minimal growth rate or regression. Patients with biopsy proven oncocytoma can be conservatively managed with active surveillance. [ABSTRACT FROM AUTHOR]

Objectives To analyse the Australian experience of high-volume Fellowship-trained Laparoscopic Radical Prostatectomy ( LRP) surgeons. Materials and Methods 2943 LRP cases were performed by nine Australian surgeons. The inclusion criteria were a prospectively collected database with a minimum of 100 consecutive LRP cases. The surgeons' LRP experience commenced at various times from July 2003 to September 2009. Data were analysed for demographic, peri-operative, oncological and functional outcomes. Results The mean age of patients were 61.5 years and mean preoperative PSA 7.4 ng/ml. Mean operating time was 168 minutes with conversion to open surgery in 0.5% and a blood transfusion rate of 1.1%. Overall mean length of stay was 2.5 days. 73.6% of pathological specimens were pT2 and 86.3% had Gleason Score >7. Overall positive surgical margins ( PSM) occurred in 15.9% with pT2 PSM 9.8%, pT3a PSM 30.8% and pT3b PSM 39.2%. Mean urinary continence at 12 months was 91.4% (data available from five surgeons). Mean 12 months potency after bilateral nerve spare was 47.2% (data available from four surgeons). Biochemical recurrence occurred in 10.6% (mean follow up 17 months). Conclusion The Australian experience of Fellowship trained surgeons performing LRP demonstrates favourable peri-operative, oncological and functional outcomes in comparison to published data for open, laparoscopic and robotic assisted radical prostatectomy. In our Australian centres, LRP remains an acceptable minimally invasive surgical treatment for prostate cancer despite the increasing use of robotic assisted surgery. [ABSTRACT FROM AUTHOR]

Background: The Useful Field of View (UFOV) test assesses divided attention/speed of processing and relates to independent activities of daily living. Cognitive training utilizing UFOV improves speed‐of‐processing and reduces dementia risk by 29%. Neural correlates of UFOV include key regions of “higher‐order” resting state networks (RSNs) involved in attention processing and dementia risk: Frontoparietal control network (FPCN), Cingulo Opercular network (CON), Default Mode network (DMN), and Dorsal Attention network (DAN). Reduced anti‐correlation between the DMN and task positive RSNs (FPCN, CON, and DAN) is reported in dementia progression. Assessing the relationship of UFOV performance with within‐ and between‐ RSN connectivity may suggest neural mechanisms of cognitive training and potential pathways for reduced dementia risk. We hypothesize that FPCN, CON, and DAN within network connectivity will predict UFOV performance, as these networks are involved in attention processing. We also predict that DMN‐CON anti‐correlation will predict UFOV performance, as this anti‐correlation is related to dementia progression. Method: 279 healthy older adults (M = 71.6, SD = 5.1) from a larger multi‐site clinical trial were recruited. UFOV performance was measured via Double Decision (DD) task from Posit Science Brain HQ. Participants correctly identified a central target, while simultaneously specifying location of a peripheral target among distractors. Average within‐network connectivity of FPCN, CON, DAN, and DMN, and between‐network connectivity of DMN‐CON, DMN‐FPCN, and DMN‐DAN were extracted from resting‐state functional magnetic resonance imaging through the CONN Toolbox v18b via SPM 12. Multiple linear regressions predicted DD performance from within‐ and between‐network values, controlling for age, sex, education, and scanner. All between‐network values were included in the same regression model. Result: Reduced CON (β=‐.134, p=.023) and FPCN (β=‐.126, p=.029) connectivity was associated with poorer DD performance. Less DMN‐CON anticorrelation demonstrated a trend for predicting better DD performance (β=‐.126, p=.060). Conclusion: Consistent with previous research, faster DD performance is associated with RSNs involved in executive functioning, attention, and processing speed. Although only trending, reduced DMN‐CON anticorrelation may be related to DD performance. This suggests that within network connectivity may contribute more to DD performance than between‐network connectivity involved in dementia progression in healthy older adults. [ABSTRACT FROM AUTHOR]

Objective To assess the influence of tumour zonality on biochemical recurrence ( BCR) after radical prostatectomy ( RP) with a histologically confirmed positive surgical margin ( PSM). Patients and Methods Data from 382 patients that underwent RP with either transition zone ( TZ) or peripheral zone ( PZ) tumours involving PSMs between 1998 and 2010 were retrieved from the Abbott West Australian Prostatectomy Database. Statistical analysis was used to evaluate the relationship of various tumour clinicopathological parameters, e.g. zonal origin of tumour, tumour volume, Gleason score, and stage to the development of BCR Results There were 51 TZ and 331 PZ tumours with PSMs identified. The TZ tumours compared with PZ tumours were larger (median 5.67 vs 3.64 mL, P < 0.001), more frequently lower grade ( Gleason score 6 33% vs 5%, P < 0.01), organ confined (51% vs 35.6%, P = 0.073), and preferentially involved the bladder neck (49% vs 6%, P < 0.001). Tumour zonality was not associated with BCR for the entire cohort. TZ and PZ tumours had similar 5-year BCR-free survival rates (58% vs 63%, P = 0.691) and comparable time to development of BCR (14.4 vs 19.2 months, P = 0.346). On univariate analysis, preoperative PSA level, PSM at the bladder neck, tumour volume, Gleason score ( P < 0.001) and tumour stage were independent predictors of BCR for the entire cohort. On multivariate analysis tumour volume and Gleason score retained significance as independent predictors of BCR. Tumour zonality was not directly associated with BCR. Of the patients who received adjuvant therapy, the incidence of BCR was similar for TZ and PZ tumours (58% vs 67%, P = 0.077), although TZ tumours failed significantly earlier (mean 4.4 vs 16.4 months, P = 0.037). Conclusions PSA recurrence in patients with histologically confirmed PSMs after RP is independent of the zonal location of the index tumour. However, tumour zonal origin may have an indirect influence on PSA relapse, as TZ tumours tend to be of large volume and more likely involve the bladder neck margin, both risk factors for BCR. Bladder neck margin involvement is associated with higher rates of BCR than other sites of PSMs. The preoperative identification of TZ tumours might aid surgical planning with appropriate alteration of RP technique to incorporate wider surgical margins at the bladder neck. Adjuvant radiotherapy appears to be associated with adverse outcome for TZ tumours, a novel finding which warrants further investigation. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to investigate whether the use of fish oil supplements (FOSs) is associated with concomitant reduction in cognitive decline and brain atrophy in older adults. Methods We conducted a retrospective cohort study to examine the relationship between FOS use during the Alzheimer's Disease Neuroimaging Initiative and indicators of cognitive decline. Older adults (229 cognitively normal individuals, 397 patients with mild cognitive impairment, and 193 patients with Alzheimer's disease) were assessed with neuropsychological tests and brain magnetic resonance imaging every 6 months. Primary outcomes included (1) global cognitive status and (2) cerebral cortex gray matter and hippocampus and ventricular volumes. Results FOS use during follow-up was associated with significantly lower mean cognitive subscale of the Alzheimer's Disease Assessment Scale and higher Mini-Mental State Examination scores among those with normal cognition. Associations between FOS use and the outcomes were observed only in APOE ε4–negative participants. FOS use during the study was also associated with less atrophy in one or more brain regions of interest. [ABSTRACT FROM AUTHOR]

Introduction Procollagen 1 amino-terminal propeptide ( P1 NP) is a bone formation marker and has been shown to have a strong association with the extent of bone metastases ( BM) in patients with advanced prostate cancer. More recently, its levels were found to be affected by androgen deprivation therapies and bisphosphonates. We investigated the role of P1 NP as a surrogate marker of sub-radiological skeletal metastases in prostate cancer patients with biochemical failure ( BF). Methods BePrepared is a prospective longitudinal substudy of RADAR trial in which serial P1 NPs were collected at regular intervals for 123 patients who had completed RADAR protocol treatment. Results There was no trend identified in P1 NP levels prior to diagnosis of BM. We found that there was no difference in P1 NP concentrations at the time of diagnosis of BM in the group that developed BM compared with P1 NP levels in groups with only nodal metastases or BF. In the group of patients who did not experience BF, P1 NP was affected by previous luteinizing hormone-releasing hormone-agonist and bisphosphonate therapy. Hence, patients who received an 18-month course of androgen deprivation without bisphosphonates had significantly higher P1 NP values than patients with shorter androgen deprivation therapy ( ADT) course combined with a course of bisphosphonates. Conclusion P1 NP is not a sensitive serum marker of early BM in high-risk prostate cancer patients with BF and low prostate-specific antigen levels as its levels are affected by prior history of bone remodelling therapies such as ADT and bisphosphonates. [ABSTRACT FROM AUTHOR]

Objective Cerebral hypoperfusion is common in heart failure (HF) and believed to underlie poor neurocognitive outcomes in this population. Up to 42% of HF patients also exhibit depressive symptomatology that may stem from reduced cerebral blood flow. However, no study has examined this possibility or whether reduced brain perfusion increases risk for future cognitive dysfunction in older adults with HF. Methods One hundred HF patients underwent transcranial Doppler ultrasonagraphy to quantify global cerebral blood flow velocity (CBF-V) and were administered a cognitive test battery to assess global cognition, attention/executive function, and memory abilities. All participants then completed the Beck Depression Inventory-II to assess depressive symptomatology. These procedures were performed at baseline and at 12-month follow-up. Results Repeated measures revealed that CBF-V declined over the 12-month period. Regression analyses showed that reduced baseline CBF-V predicted worse performances in attention/executive function ( p < 0.05 for all) and a trend for memory ( p = 0.09) in addition to greater depressive symptomatology ( p < 0.05) at the 12-month follow-up, even after controlling for baseline factors and medical and demographic variables. Conclusions Cerebral perfusion declined over time and was associated with poorer cognitive function and greater depressive symptoms at a 1-year follow-up in HF. Prospective studies with long-term follow-ups that employ neuroimaging are needed to examine whether cognitive dysfunction and depression in HF stem from the adverse effects of cerebral hypoperfusion on the cerebral structure. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective Obesity is as an independent risk factor for poor neurocognitive outcomes, including Alzheimer's disease. Bariatric surgery has recently been shown to result in improved memory at 12-weeks postoperatively. However, the long-term effects of bariatric surgery on cognitive function remain unclear. Design and Methods Eighty-six individuals (63 bariatric surgery patients, 23 obese controls) were recruited from a prospective study examining the neurocognitive effects of bariatric surgery. All participants completed self-report measurements and a computerized cognitive test battery prior to surgery and at 12-week and 24-month follow-up; obese controls completed measures at equivalent time points. Results Bariatric surgery patients exhibited high rates of pre-operative cognitive impairments in attention, executive function, memory, and language. Relative to obese controls, repeated measures ANOVA showed improvements in memory from baseline to 12-weeks and 24-months postoperatively ( P < 0.05). Regression analyses controlling for baseline factors revealed that a lower BMI at 24-months demonstrated a trend toward significance for improved memory ( β = −.30, P = 0.075). Conclusion These findings suggest that cognitive benefits of bariatric surgery may extend to 24-months postoperatively. Larger prospective studies with extended follow-up periods are needed to elucidate whether bariatric surgery decreases risk for cognitive decline and possibly the development of dementia. [ABSTRACT FROM AUTHOR]

This introduction to the Special Issue on Brand Personification was designed to provide background and perspective on the topic. Definitions of brand personification and related terminology were presented for discussion, as were two sample taxonomies of brand personification strategies. The first taxonomy entailed categorization on the basis of the personified character's relationship to the brand; five overlapping categories (including, for example, 'the brand personification is a character who personifies the brand' and 'the brand personification is a character who is a spokesperson for the brand') were distinguished and illustrated. The second taxonomy was based on the anthropomorphic qualities of personifications with reference to a reality continuum (ranging from animated cartoons to real people). The research articles presented in this Special Issue were introduced, and several questions for future research were raised. Issues related to the why and the how of brand personification were discussed (including, for example, an examination of the pros and cons of brand personification strategies). Interspersed throughout were some case histories of selected brand personifications. The applicability of dimensional qualitative research (DQR) as a tool in the academic and applied study of brand personification was illustrated with reference to each of the eight dimensions that comprise the DQR 'BASIC IDS' (an acronym for behavior, affect, sensation, imagery, cognition, interpersonal relations, drugs, and sociocultural factors). [ABSTRACT FROM AUTHOR]

Aim Cognitive impairment is common among persons with cardiovascular disease ( CVD), and several potential aetiological mechanisms have been described, including contributions of genetic markers such as variations in the brain-derived neurotrophic ( BDNF) gene. This current study examined the associations of BDNF genotype with cognitive function among individuals with CVD. Methods This study included 110 participants with CVD who completed a comprehensive neuropsychological battery that assessed global cognitive function, attention/executive function, memory, language, and visuospatial abilities. All participants also underwent blood draw to provide a DNA sample that was used to determine BDNF genotype. Carriers of either one or two copies of the methionine allele of BDNF were categorized into one group ( n = 33); non-carriers were categorized into a second group ( n = 77). Results After adjustment for demographic and medical characteristics, hierarchical regression analyses revealed persons with one or more methionine alleles displayed better performance than valine/valine individuals for attention/executive function (β = 0.22, P = 0.047) and memory (β = 0.25, P = 0.03), as well as a trend for language (β = 0.19, P = 0.08) and visuospatial abilities (β = 0.21, P = 0.06). Conclusions BDNF Val66Met had little impact on cognitive functioning in a sample of older adults with CVD, and significant findings contradicted that predicted by past work. Future work is much needed to clarify the mechanisms of these findings, particularly studies examining both circulating BDNF levels and genetic variation in the BDNF gene and cognitive function over time. [ABSTRACT FROM AUTHOR]

Objective: Cerebral hypoperfusion is common in heart failure (HF) and believed to underlie poor neurocognitive outcomes in this population. Up to 42% of HF patients also exhibit depressive symptomatology that may stem from reduced cerebral blood flow. However, no study has examined this possibility or whether reduced brain perfusion increases risk for future cognitive dysfunction in older adults with HF. Methods: One hundred HF patients underwent transcranial Doppler ultrasonagraphy to quantify global cerebral blood flow velocity (CBF-V) and were administered a cognitive test battery to assess global cognition, attention/executive function, and memory abilities. All participants then completed the Beck Depression Inventory-II to assess depressive symptomatology. These procedures were performed at baseline and at 12-month follow-up. Results: Repeated measures revealed that CBF-V declined over the 12-month period. Regression analyses showed that reduced baseline CBF-V predicted worse performances in attention/executive function (p<0.05 for all) and a trend for memory (p =0.09) in addition to greater depressive symptomatology (p<0.05) at the 12-month follow-up, even after controlling for baseline factors and medical and demographic variables. Conclusions: Cerebral perfusion declined over time and was associated with poorer cognitive function and greater depressive symptoms at a 1-year follow-up in HF. Prospective studies with long-term follow-ups that employ neuroimaging are needed to examine whether cognitive dysfunction and depression in HF stem from the adverse effects of cerebral hypoperfusion on the cerebral structure. [ABSTRACT FROM AUTHOR]

Cognitive impairment is common in heart failure ( HF) and believed to be the result of cerebral hypoperfusion and subsequent brain changes including white matter hyperintensities ( WMHs). The current study examined the association between cerebral blood flow and WMHs in patients with HF and the relationship between WMHs and cognitive impairment. Sixty-nine patients with HF completed the Mini-Mental State Examination ( MMSE) and underwent echocardiography, transcranial Doppler sonography for cerebral blood flow velocity of the middle cerebral artery, and brain magnetic resonance imaging. Multivariable hierarchical regression analyses controlling for medical and demographic characteristics as well as intracranial volume showed reduced cerebral blood flow velocity of the middle cerebral artery was associated with greater WMHs (β=−0.34, P=.02). Follow-up regression analyses adjusting for the same medical and demographic factors in addition to cerebral perfusion also revealed marginal significance between increased WMHs and poorer performance on the MMSE (β=−0.26, P=.05). This study suggests that reduced cerebral perfusion is associated with greater WMHs in older adults with HF. These findings support the widely proposed mechanism of cognitive impairment in HF patients and prospective studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Study Type - Prognosis (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Biopsy of incidentally detected small renal masses is a safe and accurate method of determining benign from malignant lesions. Renal biopsy identifies over one quarter of cases as benign; however, one in five biopsy procedures results in insufficient material for a diagnosis. The study contributes an additional 268 renal biopsy cases to the literature and further assesses the accuracy of biopsy and its ability to reduce the number of patients undergoing radical surgery for benign lesions. The results of lesions managed conservatively with follow-up are also presented. Furthermore, the study identifies an improved diagnostic trend for needle core biopsies over the period. OBJECTIVES To further validate the safety and diagnostic accuracy of percutaneous core biopsy in small renal masses ([SRMs]≤4 cm) in response to the rising prevalence of renal 'incidentalomas'., To determine the value of percutaneous core biopsy in its ability to influence the choice of intervention or surveillance for the management of SRMs., PATIENTS AND METHODS We collected data on the incidence of benign, malignant and non-diagnostic samples from 268 SRM (clinical T1a) biopsies performed at our institution between 1998 and 2009., The diagnostic accuracy of biopsy in small renal lesions was examined in cases proceeding to nephrectomy., Follow-up on the remaining non-surgical cases was performed., RESULTS SRMs (≤4 cm, clinical T1a) constituted 59% of all renal lesions diagnosed; 80% of these biopsies were diagnostic and 20% were non-diagnostic., Of the diagnostic samples, 74% were malignant and 26% were benign., Thirty-three percent (17 of the initial 52) non-diagnostic samples underwent re-biopsy, with 94% yielding a histological diagnosis on repeat sampling., Fifty-eight percent of our diagnostic masses underwent nephrectomy, returning a renal biopsy accuracy rate of 100% for identifying lesions as benign or malignant., Of the 98 observed masses, 49% were benign, 28% malignant and 23% were non-diagnostic. In 63% of these cases, size remained stable in the follow-up period., CONCLUSIONS Percutaneous core biopsy continues to provide an accurate and safe tool for preoperative tissue diagnosis of SRMs and should be offered to patients before considering surgical intervention., With regard to both benign and malignant T1a renal lesions, in select patient groups, those electing to undergo observation may expect favourable short- to medium-term outcomes. [ABSTRACT FROM AUTHOR]

Background: Much attention has been paid to the prevalence and predisposition of the fat mass and obesity-associated ( FTO) gene to obesity, although only a few studies have characterized the extent to which this affects cognitive function. This study examined differences between risk allele carriers (i.e. FTO-AC/AA) and non-carriers (i.e. FTO-CC) on indices of attention/executive function/psychomotor speed, memory, language, and visual-spatial ability in a sample of older patients with cardiovascular disease. Methods: We recruited 120 older adults from an outpatient cardiology clinic who underwent blood draw and completed neuropsychological testing. Participants were classified into two groups: one for those who were homozygous for the non-risk-conferring allele (i.e. FTO-CC) ( n= 49) and the other for those who had at least one copy of the obesity risk-conferring A allele (i.e. FTO-AC/AA) ( n= 71). Results: M ancova analyses adjusting for age and years of education revealed the FTO-AC/AA group performed significantly worse on indices of memory ( λ= 0.94, F(2, 115) = 3.58, P= 0.03, partial η2= 0.06). Follow-up tests revealed a significant effect for the FTO-AC/AA group, relative to the non-carrier group, on encoding (i.e. California Verbal Learning Test Total Learning) and California Verbal Learning Test long-delay free recall ( P < 0.05). No such differences between FTO carriers and non-carriers emerged on tests of attention/executive function/psychomotor speed, language, or visual-spatial ability ( P > 0.05 for all). Conclusions: These findings suggest that the FTO risk allele is associated with reduced memory performance, particularly on aspects of memory encoding and delayed recall. To elucidate underlying mechanisms, these findings will need to be replicated in larger samples that utilize neuroimaging. [ABSTRACT FROM AUTHOR]

As many people struggle with maintenance of weight loss, the study of successful weight loss maintainers (SWLM) can yield important insights into factors contributing to weight loss maintenance. However, little research has examined how SWLM differ from people who are obese or normal weight (NW) in brain response to orosensory stimulation. The goal of this study was to determine if SWLM exhibit different brain responses to orosensory stimulation. Brain response to 1-min orosensory stimulation with a lemon lollipop was assessed using functional magnetic resonance imaging among 49 participants, including SWLM (n = 17), NW (n = 18), and obese (n = 14) controls. Significant brain responses were observed in nine brain regions, including the bilateral insula, left inferior frontal gyrus, left putamen, and other sensory regions. All regions also exhibited significant attenuation of this response over 1 min. The SWLM exhibited greater response compared with the other groups in all brain regions. Findings suggest that the response to orosensory stimulation peaks within 40 s and attenuates significantly between 40 and 60 s in regions associated with sensation, reward, and inhibitory control. Greater reactivity among the SWLM suggests that greater sensory reactivity to orosensory stimulation, increased anticipated reward, and subsequently greater inhibitory processing are associated with weight loss maintenance. [ABSTRACT FROM AUTHOR]