Prediction of clinical diagnosis of Alzheimer's disease, vascular, mixed, and all-cause dementia by a polygenic risk score and APOE status in a community-based cohort prospectively followed over 17 years

The strongest genetic risk factor for Alzheimer's disease (AD) is the ε4 allele of Apolipoprotein E (APOE) and recent genome-wide association meta-analyses have confirmed additional associated genetic loci with smaller effects. The aim of this study was to investigate the ability of an AD polygenic risk score (PRS) and APOE status to predict clinical diagnosis of AD, vascular (VD), mixed (MD), and all-cause dementia in a community-based cohort prospectively followed over 17 years and secondarily across age, sex, and education strata. A PRS encompassing genetic variants reaching genome-wide significant associations to AD (excluding APOE) from the most recent genome-wide association meta-analysis data was calculated and APOE status was determined in 5203 participants. During follow-up, 103, 111, 58, and 359 participants were diagnosed with AD, VD, MD, and all-cause dementia, respectively. Prediction ability of AD, VD, MD, and all-cause dementia by the PRS and APOE was assessed by multiple logistic regression and receiver operating characteristic curve analyses. The PRS per standard deviation increase in score and APOE4 positivity (≥1 ε4 allele) were significantly associated with greater odds of AD (OR, 95% CI: PRS: 1.70, 1.45-1.99; APOE4: 3.34, 2.24-4.99) and AD prediction accuracy was significantly improved when adding the PRS to a base model of age, sex, and education (ASE) (c-statistics: ASE, 0.772; ASE + PRS, 0.810). The PRS enriched the ability of APOE to discern AD with stronger associations than to VD, MD, or all-cause dementia in a prospective community-based cohort.

The MADS-Box Gene MdDAM1 Controls Growth Cessation and Bud Dormancy in Apple

Apple trees require a long exposure to chilling temperature during winter to acquire competency to flower and grow in the following spring. Climate change or adverse meteorological conditions can impair release of dormancy and delay bud break, hence jeopardizing fruit production and causing substantial economic losses. In order to characterize the molecular mechanisms controlling bud dormancy in apple we focused our work on the MADS-box transcription factor gene MdDAM1. We show that MdDAM1 silencing is required for the release of dormancy and bud break in spring. MdDAM1 transcript levels are drastically reduced in the low-chill varieties 'Anna' and 'Dorsett Golden' compared to 'Golden Delicious' corroborating its role as a key genetic factor controlling the release of bud dormancy in Malus species. The functional characterization of MdDAM1 using RNA silencing resulted in trees unable to cease growth in winter and that displayed an evergrowing, or evergreen, phenotype several years after transgenesis. These trees lost their capacity to enter in dormancy and produced leaves and shoots regardless of the season. A transcriptome study revealed that apple evergrowing lines are a genocopy of 'Golden Delicious' trees at the onset of the bud break with the significant gene repression of the related MADS-box gene MdDAM4 as a major feature. We provide the first functional evidence that MADS-box transcriptional factors are key regulators of bud dormancy in pome fruit trees and demonstrate that their silencing results in a defect of growth cessation in autumn. Our findings will help producing low-chill apple variants from the elite commercial cultivars that will withstand climate change.

Integration of BpMADS4 on various linkage groups improves the utilization of the rapid cycle breeding system in apple

Rapid cycle breeding in apple is a new approach for the rapid introgression of agronomically relevant traits (e.g. disease resistances) from wild apple species into domestic apple cultivars (Malus × domestica Borkh.). This technique drastically shortens the long-lasting juvenile phase of apple. The utilization of early-flowering apple lines overexpressing the BpMADS4 gene of the European silver birch (Betula pendula Roth.) in hybridization resulted in one breeding cycle per year. Aiming for the selection of non-transgenic null segregants at the end of the breeding process, the flower-inducing transgene and the gene of interest (e.g. resistance gene) that will be introgressed by hybridization need to be located on different chromosomes. To improve the flexibility of the existing approach in apple, this study was focused on the development and characterization of eleven additional BpMADS4 overexpressing lines of four different apple cultivars. In nine lines, the flowering gene was mapped to different linkage groups. The differences in introgressed T-DNA sequences and plant genome deletions post-transformation highlighted the unique molecular character of each line. However, transgenic lines demonstrated no significant differences in flower organ development and pollen functionality compared with non-transgenic plants. Hybridization studies using pollen from the fire blight-resistant wild species accession Malus fusca MAL0045 and the apple scab-resistant cultivar 'Regia' indicated that BpMADS4 introgression had no significant effect on the breeding value of each transgenic line.

Tumor necrosis factor-dependent adhesions as a major protective mechanism early in septic peritonitis in mice

The occurrence of peritoneal adhesions in surgical patients is positively correlated with tumor necrosis factor (TNF) levels. In a model of septic peritonitis-cecal ligation and puncture-TNF neutralization prevented formation of peritoneal adhesions and increased mortality, most likely because localization of the septic focus was prevented. To discriminate between the coagulation-independent protective TNF effect and a potential protective procoagulant TNF effect, formation of peritoneal adhesions after CLP was inhibited with heparin, hirudin, or urokinase. Each treatment increased mortality and increased the number of bacteria in the peritoneal lavage fluid, kidney, and liver to various degrees. Under these experimental conditions, antibiotics prevented death. In coagulation-compromised mice, lethality was further enhanced by additional TNF neutralization. These findings demonstrate that peritoneal adhesions early in septic peritonitis are an important mechanism of innate immunity that prevents increased spread of bacteria and reduces mortality.

Biomass steam gasification--an extensive parametric modeling study

A model for steam gasification of biomass was developed by applying thermodynamic equilibrium calculations. With this model, the simulation of a decentralized combined heat and power station based on a dual fluidized-bed steam gasifier was carried out. Fuel composition (ultimate analysis and moisture content) and the operating parameters, temperature and amount of gasification agent, were varied over a wide range. Their influences on amount, composition, and heating value of product gas and process efficiencies were evaluated. It was shown that the accuracy of an equilibrium model for the gas composition is sufficient for thermodynamic considerations. Net electric efficiency of about 20% can be expected with a rather simple process. Sensitivity analysis showed that gasification temperature and fuel oxygen content were the most significant parameters determining the chemical efficiency of the gasification.

[Fractures of the proximal femur]

907 patients were operated on for fracture of the proximal femur in 1986-1987 and were then followed for an average of 7 months. There was a relatively high rate of complications in those over the age of 71, in whom mortality reached 15.5%, while the overall mortality was 6.8%. There was also a high rate of complications in those operated 3 or more days after the fracture had occurred. In those up to the age of 60, the ratio of males to females was almost 1 to 1, but in those over 80 the ratio was 1 to 4. The mortality of males was higher (9.2%) than that of females (5.5%). In trochanteric fractures treated by various methods of rigid fixation there were no problems of union or delayed union. Early mobilization and early discharge from hospital reduced mortality and complications.

Sialyltransferase activity in plasma cells of multiple myeloma

A marked elevation of sialyltransferase activity (STA) was observed in a solid tumor of plasma cells, which had been removed from a patient with multiple myeloma (MM), as compared to normal lymphatic tissues. STA was also determined in mononuclear bone marrow cells of 10 patients with MM and found to be 12 times higher than that of bone marrow mononuclear cells from 5 patients with non-malignant disorders (with less than 1% plasma cells in the bone marrow aspirate). A significant correlation was found between STA and the number of plasma cells in the bone marrow aspirate.

Continuous intraventricular morphine- or peptide-infusion for intractable cancer pain

The continuous intraventricular administration of small daily doses of morphine by means of an implantable pump is an effective method of obtaining considerable pain reduction for patients suffering from otherwise untractable carcinoma pain. We consider this method of treatment to be an excellent alternative to the epidural and intrathecal application. Particularly in cases with obstruction of the spinal canal or in cases suffering from untractable pain in the face, neck or upper thoracic area. During the period of treatment, none of the patients involved in the study developed tolerance to morphine or specific opiate side effects. The programmable pump allows precise dosage which is adjusted to the requirements of the individual patient. The high cost of a pump is a justifyable investment in patients in good general condition with a life expectancy longer than 3 months. In most cases the patient may be cared for at home, making further hospitalization unnecessary.

Foreign body granuloma. A cause of trigger thumb

Snapping or triggering of fingers is a common complaint, the most frequent cause being tenosynovitis of the flexor tendon sheath. Injury of the flexor tendon as a precursor of triggering is infrequent. Foreign body granuloma of the tendon sheath as an antecedent factor has not been yet recorded. We report a case of stenosing tenosynovitis of the flexor tendon of the thumb caused by local reaction to a foreign body.

Aneurysmal bone cyst of the first metatarsal bone mimicking malignant tumor

The clinical results of roentgenographic examination in an eight-year-old girl with a large tumor in the first metatarsus suggested malignancy. The definitive pathologic diagnosis was atypical aneurysmal bone cyst. Massive bone grafting and preservation of the surrounding joints were successful, and a functional foot was obtained two years after operation.

Lumbar spinal stenosis: surgical intervention for the older person

Twenty-one patients, aged 50 to 75 yr, received orthopedic surgery for lumbar spinal stenosis during the period of 1975-79. Presentation and management are discussed and surgical results evaluated clinically. Twenty of these patients had subjective pain relief as well as functional improvement, indicating that decompressive laminectomy offers an improved quality of life for the older person with a relatively safe, simple procedure and few postoperative complications.

Occupational stress fracture in an unusual location: report of a case in the distal end of the shaft of the radius

A 47-year-old man suffered sudden pain in his right forearm after stapling papers continuously for 3 to 4 hours a day for 3 consecutive weeks. Clinical and roentgenologic investigations revealed a tender local periosteal reaction in the distal end of the radius suggestive of a stress fracture. Follow-up investigation observations 6 years after the injury showed no unusual abnormality. To the best of our knowledge, a case of stress fracture of the distal end of the radius has not been previously reported.

Total hip replacement in a patient on hemodialysis

A 52-year-old woman, on intermittent hemodialysis because of chronic renal failure, underwent total hip replacement for severe osteoarthritic changes. The operation was performed under epidural anesthesia, the postoperative course was uneventful, and the patient was completely relieved of pain and limitation of movement. Although total hip replacement is a major surgical procedure, it is suggested that the operation can, when considered necessary, by successfully carried out in a patient on hemodialysis, provided that careful attention is paid to the pre- and postoperative care.