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Background AD is the most frequent neurodegenerative disease, severely impacting our society. Early diagnosis and prognosis are challenging tasks in the management of AD patients. New method We implemented a machine-learning classifier for the automatic early diagnosis and prognosis of AD by means of features extracted, selected and optimized from structural MRI brain images. The classifier was designed to perform multi-label automatic classification into the following four classes: HC, ncMCI, cMCI, and AD. Results From our analyses, it emerged that MMSE and hippocampus-related measures must be included as primary measures in automatic-classification systems for both the early diagnosis and the prognosis of AD. The voting scheme mainly based on the binary-classification performances on the different four groups is the best choice to model the multi-label decision function for AD, when compared with a simple majority-vote scheme or with a scheme aimed at discriminating patients with high vs low risk of conversion to AD and therapy addressing. Comparison with existing method(s) The accuracies of our binary classifications were higher than or comparable to previously published methods. An improvement is needed on the approach we used to combine binary-classification outputs to obtain the final multi-label classification. Conclusions The performance of multi-label automatic-classification systems strongly depends on the choice of the voting scheme used for combining binary-classification labels. [ABSTRACT FROM AUTHOR]

Microcystic meningioma is a rare tumor with myxoid and microcystic features. Our objective was to evaluate the efficacy of surgical resection of microcystic meningioma. Between December 1985 and October 2000 we treated 25 microcystic meningioma patients with surgical resection. We retrospectively analyzed the results including the long-term follow-up of this patient population. We identified 15 women and 10 men with a mean age of 53.8 years (24–76 years) who had microcystic meningiomas treated with surgery. Based on the Simpson grade, we found four Grade I (16%), 16 Grade II (64%), three Grade III (12%) and two Grade IV (8%) resections. The mean preoperative Karnofsky Performance Scale (KPS) score was 80.3 (range 60–100). The mean postoperative KPS score was 90.4 (range 60–100). At a mean follow-up of 101.7 months (range 16–221) the KPS score improved to a mean of 93.8. The recurrence/progression free survival (RFS/PFS) rates at 3 and 5 years were 96% and 88%, respectively. The 3 and 5 year RFS/PFS rates based on the Simpson grade were evaluated. The 3 year RFS/PFS rates for Grade I, II, III and IV were 100%, 100%, 66.6% and 100%, respectively. The 5 year RFS/PFS rates were 66.6%, 90%, 66.6% and 100%, respectively. Microcystic meningioma is a rare tumor, which is characterized by extracellular microcystic spaces filled by edematous fluid and peritumoral edema. Following surgical resection these tumors have a positive prognosis with a benign course. The surgical outcomes seem to be associated with the risks related to the surgical procedure. [ABSTRACT FROM AUTHOR]

Highlights: [•] The algorithm allows individual differential diagnosis of PD and PSP by means of MR images. [•] The algorithm does not require a priori hypotheses of where useful information may be coded in the images. [•] Classification accuracy was significantly higher compared to other published methods. [•] The algorithm was able to obtain voxel-based morphological biomarkers of PD and PSP. [ABSTRACT FROM AUTHOR]

Caspases were discovered to be responsible for directly and efficiently cleaving the amyloid-beta (A beta) precursor protein (APP) during apoptosis, which results to a rise in A beta peptide formation. It was also found that caspase-3 is the predominant caspase that induces APP cleavage. Furthermore, caspases were observed to mediate preteolypsis within the cytoplasmic tail of the APP that triggers the apoptotic death of neurons in Alzheimer's disease.

Although protein-tyrosine phosphatase 1B (PTP-1B) is a negative regulator of insulin action, adipose tissue from PTP-1B-/- mice does not show enhanced insulin-stimulated insulin receptor phosphorylation. Investigation of glucose uptake in isolated adipocytes revealed that the adipocytes from PTP-1B-/- mice have a significantly attenuated insulin response as compared with PTP-1B-/- adipocytes. This insulin resistance manifests in PTP-lB! animals older than 16 weeks of age and could be partially rescued by adenoviral expression of PTP-1B in null adipocytes. Examination of adipose signaling pathways found that the basal p70S6K activity was at least 50% higher in adipose from PTP-1B-/- mice compared with wild type animals. The increased basal activity of p70S6K in PTP-1B-/- adipose corre- lated with decreases in IR substrate-1 protein levels and insulin- stimulated Akt/protein kinase B activity, explaining the decrease in insulin sensitivity even as insulin receptor phosphorylation was unaffected. The insulin resistance of the of the PTP-1B-/- adipocytes could also be rescued by treatment with rapamycin, suggesting that in adipose the loss of PTP-1B results in basal activation of mTOR (mammalian target of rapamycin) complex 1 leading to a tissue-specific insulin resistance. [ABSTRACT FROM AUTHOR]

Demonstrates that proapoptotic BCL-2 selectively interacts with the BID-induced open conformer of BAK amino acid protein. Cascade of BAK auto-oligomerization; Interactions between BAK and BCL-2 in mitochondria; BAK conformational change and interaction with BCL-2 in intact cells overexpressing HA-BCL2.

Epidural hematoma (EDH) can result in a catastrophic outcome of traumatic brain injury. Current management guidelines do not consider the source of hemorrhage in decision making. The purpose of this study was to examine the relationship between EDH location and the source of hemorrhage. We report retrospectively reviewed, prospectively obtained surgical data of patients with acute traumatic cranial EDH treated between 2007 and 2018. Computed tomography (CT) scans were used to categorize EDH location as lateral or medial. The source of hemorrhage was identified intraoperatively by a single surgeon. Overall, of 92 evacuated EDHs (in 87 patients), 71 (77.2%) were in the lateral location. Arterial bleeding was the cause of EDH in 63.4% of the lateral EDHs and 9.2% of the medial EDHs (P < 0.0001). In the cases where surgery was done primarily to treat EDH, 65.3% had an arterial bleed source (P < 0.0001). In those treated for primary reasons other than EDH evacuation, 75% had a venous bleed source (P = 0.002). The location of EDH correlates with the source of hemorrhage. The decision to operate on EDH may be influenced by this factor. [ABSTRACT FROM AUTHOR]

Atlanto-occipital transarticular screw fixation (AOTSF) has rarely been reported for fixation of the craniovertebral junction (CVJ). A retrospective chart review of all pediatric patients (less than 18 years of age) with an attempt of AOTSF for fixation of traumatic CVJ instability was conducted. A total of 4 patients (2 boys and 2 girls; ages 2, 3, 5, and 8 years) who suffered from acute traumatic CVJ instability managed during 2007–2018 underwent an attempted AOTSF. In 2 patients, this method was technically successful. In the other 2 instances, we were not able to engage the screw into the occipital condyle. These were converted to standard occipital plate, rod, and screw fixation. All were placed in a halo subsequently for a minimum of 3 months. Three patients were fused at last follow-up (range, 17–48 months). One patient after successful AOTSF did not fuse. There were no surgical complications or revision procedures. AOTSF was feasible in half of pediatric patients suffering from traumatic CVJ instability. Therefore, intraoperative salvage options and strategies should be on hand readily. In the pediatric population, where bony anatomy may pose challenges to fixation, this technique may offer a viable first-line option in selected cases, despite the overall modest success rate. [ABSTRACT FROM AUTHOR]

Chordomas are rare, slow-growing, locally aggressive, malignant tumors of the spine. Chordomas are conventionally treated with surgical resection with or without radiation. There is an absence of literature documenting the natural history of a primary sacral chordoma. A 65-year-old man presented with rectal pain, constipation, urinary and fecal incontinence, S1 radiculopathy, and a palpable rectal mass. A needle biopsy confirmed the pathologic diagnosis of sacral chordoma. The patient declined to have surgery because of the surgical risks involved. He was managed conservatively with supportive care only. The patient was routinely followed in clinic and had a subjective and objective excellent quality of life with adequate pain management. Meanwhile, his neurologic status did not deteriorate. During follow-up, some posterolateral aspects of the chordoma regressed. However, the bulk of the lesion continued to slowly progress. The patient survived for 7.5 years. He eventually succumbed to urosepsis and new-onset peritoneal metastasis. To our knowledge, the patient is the only documented case in the literature of an untreated biopsy-proven sacral chordoma. The patient's tumor was intended for resection, and therefore comparable with data from treated chordomas. The patient's survival is similar to the median survival in treated chordomas. The patient's survival was despite negative prognosticators, such as advanced age of the patient and high sacral location above S2. [ABSTRACT FROM AUTHOR]

Anthropogenic Marine Debris (AMD) is one of the major environmental issues of our planet to date, and plastic accounts for 80% of total AMD. Beaches represent one of the main marine compartment where AMD accumulates, but few and scattered regional assessments are available from literature reporting quantitative estimation of AMD distributed on the shorelines. However, accessing information on the AMD accumulation rate on beaches, and the associated spatiotemporal oscillations, would be crucial to refining global estimation on the dispersal mechanisms. In our work, we address this issue by proposing an ad-hoc methodology for monitoring and automatically quantifying AMD, based on the combined use of a commercial Unmanned Aerial Vehicle (UAV) (equipped with an RGB high-resolution camera) and a deep-learning based software (i.e.: PlasticFinder). Remote areas were monitored by UAV and were inspected by operators on the ground to check and to categorise all AMD dispersed on the beach. The high-resolution images obtained from UAV allowed to visually detect a percentage of the objects on the shores higher than 87.8%, thus providing suitable images to populate training and testing datasets, as well as gold standards to evaluate the software performance. PlasticFinder reached a Sensitivity of 67%, with a Positive Predictive Value of 94%, in the automatic detection of AMD, but a limitation was found, due to reduced sunlight conditions, thus restricting to the use of the software in its present version. We, therefore, confirmed the efficiency of commercial UAVs as tools for AMD monitoring and demonstrated - for the first time - the potential of deep learning for the automatic detection and quantification of AMD. Unlabelled Image • Unmanned Aerial Vehicle (UAV) offers a fast and reliable survey methodology. • UAV used for Anthropogenic Marine Debris (AMD) monitoring • Spatial resolution achieved allowed to detect high percentage of AMD on the shores. • Deep-learning based software automatically detects and quantifies AMD. [ABSTRACT FROM AUTHOR]

Fluorescence-guided resection of brain tumors using 5-aminolevulinic acid (5-ALA) has been established for high-grade gliomas. Recently, its application for the resection of low grade tumors and benign lesions including meningioma has been suggested in the literature. 1 Achieving a Simpson grade I resection in meningioma surgery is associated with a lower rate of recurrence. 2,3 Although meningiomas are mostly benign and well-circumscribed lesions, they can be locally aggressive, invading brain parenchyma and other critical structures. In these cases, 5-ALA–guided resection may help maximize the extent of tumor resection and limit disruption of normal structures. In this video, we present 3 cases demonstrating the use of 5-ALA–induced fluorescence to alleviate 3 specific challenges in meningioma resection: 1) to aid visualization with a minimally invasive approach, 2) to distinguish recurrent tumor from scar tissue from prior treatments, and 3) to ensure that no viable tumor cells remain on the surface of a critical artery. The first patient is a 60-year-old woman who was found to have an incidental left sphenoid wing meningioma on magnetic resonance imaging. We elected for an extended lateral orbital craniotomy through a transpalpebral approach. The second patient is a 72-year-old man with recurrent left occipital parietal meningioma who underwent a parietal craniotomy. The third case was a 62-year-old woman with a foramen magnum meningioma encircling the left vertebral artery. These cases demonstrate the utility of 5-ALA in a variety of challenges associated with resection of meningiomas (Video 1). [ABSTRACT FROM AUTHOR]