Mechanistic Link between Vitamin B12 and Alzheimer’s Disease

Alzheimer’s disease (AD) is the most common form of dementia in the elderly population, affecting over 55 million people worldwide. Histopathological hallmarks of this multifactorial disease are an increased plaque burden and tangles in the brains of affected individuals. Several lines of evidence indicate that B12 hypovitaminosis is linked to AD. In this review, the biochemical pathways involved in AD that are affected by vitamin B12, focusing on APP processing, Aβ fibrillization, Aβ-induced oxidative damage as well as tau hyperphosphorylation and tau aggregation, are summarized. Besides the mechanistic link, an overview of clinical studies utilizing vitamin B supplementation are given, and a potential link between diseases and medication resulting in a reduced vitamin B12 level and AD are discussed. Besides the disease-mediated B12 hypovitaminosis, the reduction in vitamin B12 levels caused by an increasing change in dietary preferences has been gaining in relevance. In particular, vegetarian and vegan diets are associated with vitamin B12 deficiency, and therefore might have potential implications for AD. In conclusion, our review emphasizes the important role of vitamin B12 in AD, which is particularly important, as even in industrialized countries a large proportion of the population might not be sufficiently supplied with vitamin B12.

Quantifiable urine glyphosate levels detected in 99% of the French population, with higher values in men, in younger people, and in farmers

France is the first pesticide-consuming country in Europe. Glyphosate is the most used pesticide worldwide and glyphosate is detected in the general population of industrialized countries, with higher levels found in farmers and children. Little data was available concerning exposure in France. Our objective was to determine glyphosate levels in the French general population and to search for an association with seasons, biological features, lifestyle status, dietary habits, and occupational exposure. This study includes 6848 participants recruited between 2018 and 2020. Associated data include age, gender, location, employment status, and dietary information. Glyphosate was quantified by a single laboratory in first-void urine samples using ELISA. Our results support a general contamination of the French population, with glyphosate quantifiable in 99.8% of urine samples with a mean of 1.19 ng/ml + / − 0.84 after adjustment to body mass index (BMI). We confirm higher glyphosate levels in men and children. Our results support glyphosate contamination through food and water intake, as lower glyphosate levels are associated with dominant organic food intake and filtered water. Higher occupational exposure is confirmed in farmers and farmers working in wine-growing environment. Thus, our present results show a general contamination of the French population with glyphosate, and further contribute to the description of a widespread contamination in industrialized countries.

Investigating the Role of Having an Avatar in Virtual Reality on Pain Alleviation and Embodiment in Patients With Pain Using Electroencephalogram: A Neuroimaging Protocol

Chronic Pain (CP) is prevalent in industrialized countries and stands among the top 10 causes of disability. Given the widespread problems of pharmacological treatments such as opioids, a need to find alternative therapeutic approaches has emerged. Virtual Reality (VR) has shown potential as a non-pharmacological alternative for controlling pain over the past 20 years. The effectiveness of VR has been demonstrated in treating CP, and it has been suggested that VR’s analgesic effects may be associated with the Sense of Embodiment (SoE): the sensation of being inside, having and controlling a virtual body in VR. Studies have shown correlations among brain signals, reported pain and a SoE, and correlations have been observed between using an avatar in VR and pain alleviation among CP patients. However, little has been published about the changes in brain physiology associated with having an avatar in VR, and current published studies present methodological issues. Defining a proper methodology to investigate the underlying brain mechanisms of pain, a SoE associated with having an avatar in VR, and its effect on reducing pain in CP patients is key to the emerging field of VR-analgesia. Here, we propose an intervention trial design (test/intervention/test) to evaluate the effects of having a virtual avatar in VR on pain levels and SoE in CP patients using Electroencephalogram (EEG) recordings. Resting-state EEG recordings, perceived pain levels, and SoE scores will be collected before and after the VR intervention. Patients diagnosed with CP will be recruited from local pain clinics and pseudo-randomly assigned to one of two groups—with or without an avatar. Patients will experience a 10-min VR intervention built to treat CP while their EEG signals are recorded. In articulating the study procedure, we propose a framework for future studies that explores the mechanisms of VR-analgesia in patients with chronic pain.

Diabetes Distal Peripheral Neuropathy: Subtypes and Diagnostic and Screening Technologies

Diabetes distal symmetrical peripheral neuropathy (DSPN) is the most prevalent form of neuropathy in industrialized countries, substantially increasing risk for morbidity and pre-mature mortality. DSPN may manifest with small-fiber disease, large-fiber disease, or a combination of both. This review summarizes: (1) DSPN subtypes (small- and large-fiber disease) with attention to clinical signs and patient symptoms; and (2) technological diagnosis and screening for large- and small-fiber disease with inclusion of a comprehensive literature review of published studies from 2015-present ( N = 66). Review findings, informed by the most up-to-date research, advance critical understanding of DSPN large- and small-fiber screening technologies, including those designed for point-of-care use in primary care and endocrinology practices.

Impact of nutritional status on heart failure mortality: a retrospective cohort study

Background Chronic heart failure (CHF) is one of the most common causes of mortality in industrialized countries despite regular therapeutic advances. Numerous factors influence mortality in CHF patients, including nutritional status. It is known that malnutrition is a risk factor for mortality, whereas obesity may play a protective role, a phenomenon dubbed the “obesity paradox”. However, the effect of the obesity-malnutrition association on mortality has not been previously studied for CHF. Our aim was to study the effect of nutritional status on overall mortality in CHF patients. Methods This retrospective, multicenter study was based on a French nationwide database (PMSI). We included all CHF patients aged ≥18 years admitted to all public and private hospitals between 2012 and 2016 and performed a survival analysis over 1 to 4 years of follow-up. Results Malnutrition led to a significant decrease in life expectancy in CHF patients when compared with normal nutritional status (aHR=1.16 [1.14-1.18] at one year and aHR=1.04 [1.004-1.08] at four years), obese, and obese-malnutrition groups. In contrast, obesity led to a significant increase in life expectancy compared with normal nutritional status (aHR=0.75 [0.73-0.78] at one year and aHR=0.85 [0.81-0.90] at four years), malnutrition, and obese-malnutrition groups. The mortality rate was similar in patients presenting both malnutrition and obesity and patients with normal nutritional status. Conclusions Our results indicate that the protective effect on mortality observed in obese CHF patients seems to be linked to fat massincrease. Furthermore, malnourished obese and normal nutritional status patients had similar mortality rates. Further studies should be conducted to confirm our results and to explore the physiopathological mechanisms behind these effects.

Current Standards for and Clinical Impact of Emergency Radiology in Major Trauma

In industrialized countries, high energy trauma represents the leading cause of death and disability among people under 35 years of age. The two leading causes of mortality are neurological injuries and bleeding. Clinical evaluation is often unreliable in determining if, when and where injuries should be treated. Traditionally, surgery was the mainstay for assessment of injuries but advances in imaging techniques, particularly in computed tomography (CT), have contributed in progressively changing the classic clinical paradigm for major traumas, better defining the indications for surgery. Actually, the vast majority of traumas are now treated nonoperatively with a significant reduction in morbidity and mortality compared to the past. In this sense, another crucial point is the advent of interventional radiology (IR) in the treatment of vascular injuries after blunt trauma. IR enables the most effective nonoperative treatment of all vascular injuries. Indications for IR depend on the CT evidence of vascular injuries and, therefore, a robust CT protocol and the radiologist’s expertise are crucial. Emergency and IR radiologists form an integral part of the trauma team and are crucial for tailored management of traumatic injuries.

Gut microbiomes from Gambian infants reveal the development of a non-industrialized Prevotella-based trophic network

Distinct bacterial trophic networks exist in the gut microbiota of individuals in industrialized and non-industrialized countries. In particular, non-industrialized gut microbiomes tend to be enriched with Prevotella species. To study the development of these Prevotella-rich compositions, we investigated the gut microbiota of children aged between 7 and 37 months living in rural Gambia (616 children, 1,389 stool samples, stratified by 3-month age groups). These infants, who typically eat a high-fibre, low-protein diet, were part of a double-blind, randomized iron intervention trial (NCT02941081) and here we report the secondary outcome. We found that child age was the largest discriminating factor between samples and that anthropometric indices (collection time points, season, geographic collection site, and iron supplementation) did not significantly influence the gut microbiome. Prevotella copri, Faecalibacterium prausnitzii and Prevotella stercorea were, on average, the most abundant species in these 1,389 samples (35%, 11% and 7%, respectively). Distinct bacterial trophic network clusters were identified, centred around either P.stercorea or F.prausnitzii and were found to develop steadily with age, whereas P.copri, independently of other species, rapidly became dominant after weaning. This dataset, set within a critical gut microbial developmental time frame, provides insights into the development of Prevotella-rich gut microbiomes, which are typically understudied and are underrepresented in western populations.

Macroeconomic Policy Changes and Its Impact on Trade Unions, an Empirical Study on OECD Countries for the Period 2001-2020

This study examines the macroeconomic variables affecting trade union rate membership in OECD nations from 2001 to 2020. The Organization for Economic Cooperation and Development (OECD) has 38 of the most industrialized countries globally, which counts more than 80% of the global GDP; analyzing the macroeconomic movements of these countries means that we most likely know the variance of the global macroeconomic changes. We target the effect of employability, expenditure on education, unemployment, inflation, FDI, economic growth, wages, and salaries on trade union participation of employers. To conduct this research, we used data from World Bank, ILO, and OECD for 38 countries during the period 2001-2020, conducting a panel data Fixed Effect non-linear regression model with robust effect considering the non-normality and the possibility of heteroscedasticity of some of the variables. The results show that employers in the industry, the productivity in the service sector, and wages will increase the enrolment in a trade union, but on the other side, an increase of FDI and unemployment rates will decrease the association of employers to be in a trade union.

Involvement of 'Outsiders' in the Arctic Region

Since ancient times people have had access to the Arctic Circle, however, the last few decades have seen recent technological advancements that have allowed the area to be explored more comprehensively. This has created a significantly more complex picture than before as it has been called the new “Great Game.” With the rising interests of eight nations and other non-Arctic countries in the region, overlapping territorial claims have the potential to create new challenges. It is anticipated that increased interest will lead to an increase in the number of vessels transiting the region, despite harsh climate conditions. Meanwhile, the Arctic is experiencing environmental change that is inescapably leading to a new geopolitical reality. Authors, such as Jason Dittmer, have claimed that “The Arctic is evolving from a regional frozen backwater into a global hot issue.” This article discusses the colliding interests and current state of affairs of the three Arctic Council Asian observer countries, China, Japan, and South Korea, as well as those of two observer organizations, the United Nations Environment Programme (UNEP) and the European Union (EU). Sustainability is one of the major priorities of these countries, which has been reflected in their Arctic policies. The reason for examining China, Japan, and South Korea is that they are growing superpowers and industrialized countries with varying interests in regards to the Arctic region.

Metabolic Therapy of Heart Failure: Is There a Future for B Vitamins?

Heart failure (HF) is a plague of the aging population in industrialized countries that continues to cause many deaths despite intensive research into more effective treatments. Although the therapeutic arsenal to face heart failure has been expanding, the relatively short life expectancy of HF patients is pushing towards novel therapeutic strategies. Heart failure is associated with drastic metabolic disorders, including severe myocardial mitochondrial dysfunction and systemic nutrient deprivation secondary to severe cardiac dysfunction. To date, no effective therapy has been developed to restore the cardiac energy metabolism of the failing myocardium, mainly due to the metabolic complexity and intertwining of the involved processes. Recent years have witnessed a growing scientific interest in natural molecules that play a pivotal role in energy metabolism with promising therapeutic effects against heart failure. Among these molecules, B vitamins are a class of water soluble vitamins that are directly involved in energy metabolism and are of particular interest since they are intimately linked to energy metabolism and HF patients are often B vitamin deficient. This review aims at assessing the value of B vitamin supplementation in the treatment of heart failure.