Citations

AbstractObjectiveEpilepsy raises critical challenges to accurately localize the epileptogenic zone (EZ) to guide presurgical planning. Previous research has suggested that interictal spikes overlapping with high‐frequency oscillations, referred to here as pSpikes, serve as a reliable biomarker for EZ estimation, but there remains a question as to whether and to how pSpikes perform as compared to other types of epileptic spikes. This study aims to address this question by investigating the source imaging capabilities of pSpikes alongside other spike types.MethodsA total of 2819 interictal spikes from 76‐channel scalp electroencephalography (EEG) were analyzed in a cohort of 24 drug‐resistant focal epilepsy patients. All patients received surgical resection, and 16 were declared seizure‐free based on at least 1 year of postoperative follow‐up. A recently developed electrophysiological source imaging algorithm—fast spatiotemporal iteratively reweighted edge sparsity (FAST‐IRES)—was used for source imaging of the detected interictal spikes. The performance of 217 pSpikes was compared with 772 nSpikes (spikes with irregular high‐frequency activations), 1830 rSpikes (spikes with no high‐frequency activity), and all 2819 aSpikes (all interictal spikes).ResultsThe localization and extent estimation using pSpikes are concordant with the clinical ground truth; using pSpikes yields the best performance compared with nSpikes, rSpikes, and conventional spike imaging (aSpikes). For multiple spike type seizure‐free patients, the mean localization error for pSpike imaging was 6.8 mm, compared with 15.0 mm for aSpikes. The sensitivity, precision, and specificity were .41, .67, and .93 for pSpikes compared with .32, .48, and .93 for aSpikes.SignificanceThese results demonstrate the merits of noninvasive EEG source localization, and that (1) pSpike is a superior biomarker, outperforming conventional spike imaging for the localization of epileptic sources, and especially those with multiple irritative zones; and (2) FAST‐IRES provides accurate source estimation that is highly concordant with clinical ground truth, even in situations of single spike analysis with low signal‐to‐noise ratio.

AbstractBackground and ObjectivesSubstance use disorders (SUD) are a major public health concern in the United States. This study examined racial/ethnic and state‐level disparities in SUD mortality in the United States from 2000 to 2019.MethodsAge‐standardized mortality rates for SUD were obtained for 5 racial/ethnic groups (White respondents, Black respondents, Latino, Asian‐Pacific Islander [API], American Indian/Alaska Native [AIAN]) by state and sex from 2000 to 2019. Joinpoint regression analysis was used to model temporal trends overall and by demographic factors.ResultsFrom 2000 to 2019, the overall mortality rate increased from 8.0 to 28.8 deaths per 100,000 population across all groups. AIANs had the highest mortality in 2019 (57.8 per 100,000), followed by Black respondents, White respondents, Latinos, and APIs. Significant increases occurred across all racial/ethnic groups, with the greatest average annual percentage change (AAPC2000–2019) among White respondents (6.7%; 95% confidence interval [CI]: 6.2%–7.3%), APIs (6.0%, 95% CI: 5.6%–6.2%), and AIANs (5.9%, 95% CI: 5.6%–6.2%). Mortality rates increased more rapidly for females than males among White respondents, AIANs, Black respondents, and Latinos. Substantial state‐level variation emerged, with the highest mortality rates in 2019 seen in West Virginia, the District of Columbia, Delaware, Ohio, and Pennsylvania.Discussion and ConclusionsRacial/ethnic and geographic disparities in SUD mortality have widened significantly from 2000 to 2019, highlighting priority areas for prevention efforts.Scientific SignificanceThis study provides detailed insights into long‐term trends in racial, ethnic, and geographic disparities in SUD mortality across the United States, informing targeted prevention and intervention strategies.

Abstract Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating toxicity of many drugs used in cancer treatment. There are numerous available strategies for preventing or treating CIPN, but few are guideline-recommended, due to limited evidence of their effectiveness. The primary objective of this survey was to understand what strategies patients used to prevent or treat CIPN, and to understand their perceptions around CIPN prevention and treatment. Methods: The Multinational Association of Supportive Care in Cancer (MASCC) Neurological Complications Study Group created a cross-sectional online survey to recruit individuals who are currently or had previously received neurotoxic chemotherapy treatment and self-reported peripheral neuropathy. Descriptive statistics were reported. Results: Most of the 447 survey participants did not use any CIPN prevention strategy (71%), though given options of any strategy the plurality preferred a prescribed medication or supplement (30%). The most common treatment strategy used was exercise (47%), with some patients trying prescription medications including non-guideline recommended gabapentin (33%) or guideline-recommended duloxetine (8%) options. Nearly half of participants (49%) used at least one non-prescribed medication for treating CIPN. Patient’s often followed suggestions of their medical oncology clinical team, but sometimes relied on the internet or other patients to recommend non-prescription strategies. Conclusion: In the absence of many guideline-recommended strategies for CIPN prevention and treatment, some patients use options with minimal evidence of effectiveness. Additional research is needed to determine which strategies are effective for prevention and treatment so these can be implemented in practice to improve treatment outcomes in patients with cancer.

Abstract The Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection continues to expand its horizon through the development of diverse symptoms, particularly concerning long COVID. The patients infected with the SARS-CoV-2 are being reported to develop new symptoms such as brain fog, fatigue, and other symptoms that are not limited to the respiratory system. The SARS-CoV-2 utilizes the human ion channels (HICs) and molecules involved in lipid metabolism from their entry to their egress. Here, to identify molecular alterations in HICs and lipid metabolism-related genes, transcriptomic data of 277 SARS-CoV-2 infected patients were analyzed. 287 HICs and 754 lipid metabolism-related genes were found to be differentially expressed in SARS-CoV-2 infected patients. Further, an interactome of altered HICs and lipid metabolism-related proteins with SARS-CoV-2 proteins was generated. Extensive data mining approach was employed to generate a pathway map highlighting alteration in several pathways including calcium signaling, long-term depression, and cholesterol metabolism in SARS-CoV-2 infected patients. Moreover, 17 potential drugs with known modes of action that interact with 4 altered HICs including inositol 1,4,5-triphosphate (InsP3) receptors and gap junction protein alpha 1 were identified. Most likely, these HICs are potential candidates for drug repurposing in patients infected with SARS-CoV-2 and require further experimental validation.

AbstractINTRODUCTIONWe evaluated impaired odor identification and global cognition as simple, cost‐effective alternatives to neuroimaging biomarkers to predict cognitive decline and dementia in the Mayo Clinic Study of Aging.METHODSSix hundred forty‐seven participants (mean 8.1, standard deviation 3.4 years’ follow‐up) had the following baseline procedures: modified Blessed Information Memory Concentration Test (BIMCT), 12‐item Brief Smell Identification Test (BSIT), structural brain magnetic resonance imaging (MRI), and positron emission tomography (PET) imaging with 11C‐Pittsburgh compound B (11C‐PiB) and fluorodeoxyglucose (FDG; subset).RESULTSCognitive decline developed in 102 participants and dementia in 34 participants. In survival analyses, PiB PET showed robust prediction for cognitive decline. Impaired BSIT, impaired BIMCT, MRI, and FDG measures were also significant predictors. The combination of demographics + BSIT + BIMCT showed strong predictive utility (C‐index 0.81), similar to demographics + PiB PET (C‐index 0.80). Similar but stronger results were obtained for prediction of dementia.DISCUSSIONImpairment in both odor identification test and global cognition was comparable to PiB PET for predicting cognitive decline and dementia.Highlights In 647 participants in the population‐based Mayo Clinic Study of Aging, several clinical markers and biomarkers each predicted cognitive decline or dementia during an average 8 years of follow‐up. The combination of the demographic variables of age, sex, and education with a brief odor identification test (BSIT) and a global cognitive test (Blessed Information Memory Concentration Test) showed strong predictive utility (C‐index 0.81) for cognitive decline that was similar to the demographic variables combined with Pittsburgh Compound B amyloid imaging (C‐index 0.80). Combining a brief odor identification test with a brief cognitive test needs consideration as a simple, cost‐effective option in the clinical assessment of individuals at risk of cognitive decline and dementia, as well as a potential tool to identify individuals who may benefit from disease‐modifying treatments and to screen participants for prevention trials.

ABSTRACT Hepatic angiosarcoma is a rare and aggressive liver tumor. We report a case study of an 82-year-old elderly gentleman who presented with failure to thrive and ascites. Initially suspected to be cirrhosis, biopsy results eventually concluded angiosarcoma of the liver. Our patient presented with an infiltrative form, rather than distinct masses, which led to portal hypertension and ascites. The variance in symptomatology and radiology presentations make a diagnosis of hepatic angiosarcoma challenging and require a high index of suspicion.