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While the vast majority of Alzheimer's disease (AD) is non-familial, the animal models of AD that are commonly used for studying disease pathogenesis and development of therapy are mostly of a familial form. We aimed to generate a model reminiscent of the etiologies related to the common late-onset Alzheimer's disease (LOAD) sporadic disease that will recapitulate AD/dementia features. Naïve female mice underwent ovariectomy (OVX) to accelerate aging/menopause and were fed a high fat-sugar-salt diet to expose them to factors associated with increased risk of development of dementia/AD. The OVX mice fed a high fat-sugar-salt diet responded by dysregulation of glucose/insulin, lipid, and liver function homeostasis and increased body weight with slightly increased blood pressure. These mice developed AD-brain pathology (amyloid and tangle pathologies), gliosis (increased burden of astrocytes and activated microglia), impaied blood vessel density and neoangiogenesis, with cognitive impairment. Thus, OVX mice fed on a high fat-sugar-salt diet imitate a non-familial sporadic/environmental form of AD/dementia with vascular damage. This model is reminiscent of the etiologies related to the LOAD sporadic disease that represents a high portion of AD patients, with an added value of presenting concomitantly AD and vascular pathology, which is a common condition in dementia. Our model can, thereby, provide a valuable tool for studying disease pathogenesis and for the development of therapeutic approaches.

Objective: To estimate incidence and case-fatality rates of amniotic fluid embolism (AFE) and to examine their temporal trends., Study Design: Population-based retrospective cohort study using the 2000-2019 Health Care Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS). Annual population rates were estimated using HCUP-NIS specific weighting. Descriptive analyses and logistic regression described trends within the cohort., Results: Over the study period, AFE incidence rate remained stable (mean 4.9 cases/100,000 deliveries) and the case-fatality rate declined (mean 17.7 %,95 % CI 16.40-10.09). Highest AFE incidence rates and fatality rates were in women ≥ 35 years, African-Americans, and in urban-teaching hospitals. AFE mortality rates decreased among Hispanics., Conclusion: AFE rates remained stable and fatality rates declined over time. Highest rates of AFE occurrence and death were in women who typically have greater risk of experiencing adverse obstetrical outcomes. Continued research into early diagnostic methods and effective treatments are needed to further improve AFE incidence and mortality rates., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Ultrasound guided nerve blocks are increasingly being used in perioperative care as a means of safely delivering analgesia. Unfortunately, identifying nerves in ultrasound images presents a challenging task for novice anesthesiologists. Drawing from online resources, here we attempted to address this issue by developing a deep learning algorithm capable of automatically identifying the transversus abdominis plane region in ultrasound images. Training of our dataset was done using the U-Net architecture and artificial augmentation was done to optimize our training dataset. The Dice score coefficient was used to evaluate our model, with further evaluation against a test set composed of manually drawn labels from a pool of (n=10) expert anesthesiologists.Across all labelers the model achieved a global Dice score of 73.31% over the entire test set. These preliminary results highlight the potential effectiveness of this model as a future ultrasound decision support system in the field of anesthesia.

Lumbar punctures present a specific challenge in various medical specialties; appropriate simulators need to take into account the specific technical difficulties related to a realistic patient population, but currently fail to address the variety of anatomical differences seen in practice. We interviewed several leaders in the field of anesthesiology with extensive experience in lumbar puncture procedures, subsequently developing a more realistic training simulator. This novel simulator was built using silicone-based materials and advanced 3D-printing techniques, specifically tailored to be capable of mimicking a variety of patient populations without having to dispose of essential components after each use. Two Anesthesiologists with at least 20 years of experience were asked to perform several spinal tap procedures. Following testing, experts rated the simulator based on its procedural realism, usefulness in improving skill set, and overall simulation efficacy.The gathered validation outcomes based on the questionnaire evaluations completed by experts show excellent preliminary results, with an overall mean score of 4.8 out of 5 (96%). These preliminary results highlight the potential for the simulator's application as a tool to improve medical simulation education and future patient outcomes.

We recently reported the benefit of the IV transferring of active exogenous mitochondria in a short-term pharmacological AD (Alzheimer's disease) model. We have now explored the efficacy of mitochondrial transfer in 5XFAD transgenic mice, aiming to explore the underlying mechanism by which the IV-injected mitochondria affect the diseased brain. Mitochondrial transfer in 5XFAD ameliorated cognitive impairment, amyloid burden, and mitochondrial dysfunction. Exogenously injected mitochondria were detected in the liver but not in the brain. We detected alterations in brain proteome, implicating synapse-related processes, ubiquitination/proteasome-related processes, phagocytosis, and mitochondria-related factors, which may lead to the amelioration of disease. These changes were accompanied by proteome/metabolome alterations in the liver, including pathways of glucose, glutathione, amino acids, biogenic amines, and sphingolipids. Altered liver metabolites were also detected in the serum of the treated mice, particularly metabolites that are known to affect neurodegenerative processes, such as carnosine, putrescine, C24:1-OH sphingomyelin, and amino acids, which serve as neurotransmitters or their precursors. Our results suggest that the beneficial effect of mitochondrial transfer in the 5XFAD mice is mediated by metabolic signaling from the liver via the serum to the brain, where it induces protective effects. The high efficacy of the mitochondrial transfer may offer a novel AD therapy.