A Comparative Study of Site-Specific Distribution of Aging-Related Tau Astrogliopathy and Its Risk Factors Between Alzheimer Disease and Cognitive Healthy Brains: The Hisayama Study

Knowledge of aging-related tau astrogliopathy (ARTAG) in healthy elderly individuals remains incomplete and studies to date have not focused on the olfactory nerve, which is a vulnerable site of various neurodegenerative disease pathologies. We performed a semiquantitative evaluation of ARTAG in 110 autopsies in the Japanese general population (Hisayama study). Our analysis focused on Alzheimer disease (AD) and cognitive healthy cases (HC), including primary age-related tauopathy. Among the various diseased and nondiseased brains, ARTAG was frequently observed in the amygdala. The ARTAG of HC was exclusively limited to the amygdala whereas gray matter ARTAG in AD cases was prominent in the putamen and middle frontal gyrus following the amygdala. ARTAG of the olfactory nerve mainly consists of subpial pathology that was milder in the amygdala. A logistic regression analysis revealed that age at death and neurofibrillary tangle Braak stage significantly affected the ARTAG of HC. In AD, age at death and male gender had significant effects on ARTAG. In addition, the Thal phase significantly affected the presence of white matter ARTAG. In conclusion, our research revealed differences in the distribution of ARTAG and affected variables across AD and HC individuals.

Repeatability and reproducibility of quantitative cervical strain elastography (E-Cervix) in pregnancy

Strain elastography of the uterine cervix may be useful in the diagnosis and prediction of obstetric complications. The inability to obtain quantitative results, with only the possibility of visual semiquantitative evaluation of the obtained elastograms, has been the limitation of the method thus far. E-Cervix is a software program that uses intrinsic compression to excite tissue and allows the evaluation of quantitative parameters on the basis of pixel distribution in an elastogram. The aim of this study was to assess the repeatability and reproducibility of quantitative cervical strain elastography (E-Cervix) of the uterine cervix and to assess the correlation of the obtained parameters with selected clinical features of patients in the third trimester of pregnancy. In total, 222 patients participated in the study. We assessed 5 ultrasound parameters: elasticity index (ECI), hardness ratio (HR), internal os strain (IOS), external os strain (EOS) and IOS/EOS ratio. Each study was performed according to a predetermined standardized protocol. For all assessed elastographic parameters, we obtained good intra- and interobserver reproducibility. The interclass correlation coefficient (ICC) ranged from 0.77 to 0.838 for intraobserver variability and from 0.771 to 0.826 for interobserver variability. We demonstrated a significant correlation of some obtained elastographic parameters with the basic clinical features of patients, such as age, the number of previous caesarean sections, pregnancy weight and BMI. In each case, the correlation was very low. Quantitative elastographic assessment with the use of E-Cervix is characterized by good repeatability. Some clinical features may affect the value of the parameters obtained. The clinical relevance of this interference requires further investigation.

A Mineralogical Museum as a Geotourism Attraction: A Case Study

The Zaruma-Portovelo mining district in Ecuador, and in particular, Portovelo City, is home to the oldest mining museum in the country. This museum, named Museo Mineralógico Magner Turner (MMMT in Spanish), is a centre that reflects, through its collections, the history and culture of this territory. This work aimed to evaluate the MMMT as a possible geosite by analysing its contributions to the geomining heritage of the Zaruma-Portovelo district, and thus, to enhance it and promote its collections as a geotouristic attraction. The work involved three phases: (i) describing the museum and its surroundings; (ii) a semiquantitative evaluation of the museum using the Brilha method and a geosites assessment model (GAM); and (iii) a qualitative evaluation using the Delphi and SWOT methodologies to define strategies and proposals for museum development. The results obtained by the semiquantitative evaluation of the geosite with the Brilha method reflect high scientific (330/400), educational (380/400) and touristic (365/400) appeal. The applied GAM shows the museum as a geosite with high principal and additional value, placing it in the Z33 field of the global valuation matrix. In addition, the semiquantitative and qualitative evaluation made it possible to describe the importance of the museum and its collections in the development of the area. The study carried out qualified the museum as a mining site with an appropriate valuation, an example of ex-situ geological heritage conservation and a basis for geotourism development.

Keyhole Endoscopic-Assisted Transcervical Approach to the Upper and Middle Retrostyloid Parapharyngeal Space: An Anatomic Feasibility Study

Objectives The aim of this study was to describe the anatomical nuances, feasibility, limitations, and surgical exposure of the parapharyngeal space (PPS) through a novel minimally invasive keyhole endoscopic-assisted transcervical approach (MIKET). Design Descriptive cadaveric study. Setting Microscopic and endoscopic high-quality images were taken comparing the MIKET approach with a conventional combined transmastoid infralabyrinthine transcervical approach. Participants Five colored latex-injected specimens (10 sides). Main Outcome Measures Qualitative anatomical descriptions in four surgical stages; quantitative and semiquantitative evaluation of relevant landmarks. Results A 5 cm long inverted hockey stick incision was designed to access a corridor posterior to the parotid gland after independent mobilization of nuchal and cervical muscles to expose the retrostyloid PPS. The digastric branch of the facial nerve, which runs 16.5 mm over the anteromedial part of the posterior belly of the digastric muscle before piercing the parotid fascia, was used as a landmark to identify the main trunk of the facial nerve. MIKET corridor was superior to the crossing of the accessory nerve over the internal jugular vein within 17.3 mm from the jugular process. Further exposure of the occipital condyle, vertebral artery, and the jugular bulb was achieved. Conclusion The novel MIKET approach provides in the cadaver straightforward access to the upper and middle retrostyloid PPS through a natural corridor without injuring important neurovascular structures. Our work sets the anatomical nuances and limitations that should guide future clinical studies to prove its efficacy and safety either as a stand-alone procedure or as an adjunct to other approaches, such as the endonasal endoscopic approach.

Semiquantitative Methods for GFP Immunohistochemistry and In Situ Hybridization to Evaluate AAV Transduction of Mouse Retinal Cells Following Subretinal Injection

The goal of this study was to develop methods for the evaluation of green fluorescent protein (GFP) and GFP transcript biodistribution in paraformaldehyde-fixed paraffin-embedded (PFPE) eye sections to assess the effectiveness of Adeno-associated virus (AAV) gene delivery in an experimental ocular toxicity study. Female C57BL/6NTac mice were administered AAV2-enhancedGFP vector once via subretinal injection. One group also received anti-inflammatory therapy (meloxicam). Immunohistochemistry (IHC) and RNA in situ hybridization (ISH) for GFP were performed on PFPE serial eye sections and evaluated using semiquantitative methods. On day 43, GFP labeling in both IHC and ISH sections was greatest in the retinal pigment epithelium, compared with other retinal layers in which expression was negative to moderate. Despite the presence of IHC GFP labeling in the photoreceptor layer (PRL) in some animals, only low numbers of transduced cells were detected by ISH in the PRL. Simultaneous analysis of IHC and ISH may be needed for comprehensive assessment of gene transduction and protein biodistribution. This study demonstrates approaches for semiquantitative evaluation of IHC and ISH that allow interpretation and reporting of GFP expression in toxicity studies.

Radiological Thoracic Vertebral Fractures are Highly Prevalent in COVID-19 and Predict Disease Outcomes

Context and Objective COVID-19 has become the most relevant medical issue globally. Despite several studies that have investigated clinical characteristics of COVID-19 patients, no data have been reported on the prevalence of vertebral fractures (VFs). Since VFs may influence cardiorespiratory function and disease outcomes, the aim of this study was to assess VFs prevalence and clinical impact in COVID-19. Design and Patients This was a retrospective cohort study performed at San Raffaele Hospital, a tertiary health care hospital in Italy. We included COVID-19 patients for whom lateral chest x-rays at emergency department were available. VFs were detected using a semiquantitative evaluation of vertebral shape on chest x-rays. Results A total of 114 patients were included in this study and thoracic VFs were detected in 41 patients (36%). Patients with VFs were older and more frequently affected by hypertension and coronary artery disease (P < 0.001, P = 0.007, P = 0.034; respectively). Thirty-six (88%) patients in VFs+ group compared to 54 (74%) in VFs− group were hospitalized (P = 0.08). Patients with VFs more frequently required noninvasive mechanical ventilation compared with those without VFs (P = 0.02). Mortality was 22% in VFs+ group and 10% in VFs− group (P = 0.07). In particular, mortality was higher in patients with severe VFs compared with those with moderate and mild VFs (P = 0.04). Conclusions VFs may integrate the cardiorespiratory risk of COVID-19 patients, being a useful and easy to measure clinical marker of fragility and poor prognosis. We suggest that morphometric thoracic vertebral evaluation should be performed in all suspected COVID-19 patients undergoing chest x-rays.

Evaluation of the In Vivo Biocompatibility of Amorphous Calcium Phosphate-Containing Metals

Among the biomaterials based on calcium phosphate, hydroxyapatite has been widely used due to its biocompatibility and osteoconduction. The substitution of the phosphate group by the carbonate group associated with the absence of heat treatment and low synthesis temperature leads to the formation of carbonated hydroxyapatite (CHA). The association of CHA with other metals (strontium, zinc, magnesium, iron, and manganese) produces amorphous calcium phosphate-containing metals (ACPMetals), which can optimize their properties and mimic biological apatite. This study aimed to evaluate the biocompatibility and biodegradation of ACPMetals in mice subcutaneous tissue. The materials were physicochemically characterized with Fourier Transform InfraRed (FTIR), X-Ray Diffraction (XRD), and Atomic Absorption Spectrometry (AAS). Balb-C mice (n = 45) were randomly divided into three groups: carbonated hydroxyapatite, CHA (n = 15), ACPMetals (n = 15), and without implantation of material (SHAM, n = 15). The groups were subdivided into three experimental periods (1, 3, and 9 weeks). The samples were processed histologically for descriptive and semiquantitative evaluation of the biological effect of biomaterials according to ISO 10993-6:2016. The ACPMetals group was partially biodegradable; however, it presented a severe irritating reaction after 1 and 3 weeks and moderately irritating after nine weeks. Future studies with other concentrations and other metals should be carried out to mimic biological apatite.