Introduction La maladie d’Alzheimer et le MCI s’accompagnent d’altérations précoces et reproductibles de l’activité EEG, pouvant servir de biomarqueurs objectifs du déclin cognitif. Objectifs Identifier les paramètres EEG les plus discriminants et évaluer leur capacité prédictive du déclin cognitif grâce à des modèles de deep learning interprétables. Méthodes Étude rétrospective basée sur des enregistrements EEG au repos (10–30 premières secondes) obtenus chez des patients AD, MCI et témoins. Les signaux ont été prétraités et convertis en format EDF. Une extraction systématique des caractéristiques fréquentielles, temporelles et non linéaires a été réalisée. Des modèles convolutionnels et attentionnels ont été entraînés, avec interprétation par Grad-CAM et analyses d’occlusion. Résultats Les analyses préliminaires montrent une nette différenciation entre groupes. Les biomarqueurs les plus contributifs incluent l’augmentation du pouvoir delta-thêta, la réduction des bandes alpha, ainsi que plusieurs indices de connectivité fonctionnelle. Les cartes attentionnelles localisent les anomalies principalement dans les régions temporo-pariétales. Discussion Ces premiers résultats suggèrent que les biomarqueurs EEG dérivés du deep learning sont sensibles aux altérations cognitives subtiles. Les approches interprétables permettent d’identifier les zones corticales et les paramètres déterminants, renforçant l’intérêt clinique des analyses automatisées dans le diagnostic précoce. Conclusion Le deep learning appliqué à l’EEG constitue un outil prometteur et interprétable pour prédire le déclin cognitif dans l’AD et le MCI. Informations complémentaires – remerciements, financements, etc Le projet a reçu l’approbation du Comité d’éthique de la Chambre médicale d’Opole sous le numéro OIL/KB/356/25.
The purpose of the study was to collect and summarise information available in the scientific literature on the probable reasons that lead to negative outcomes of COVID-19 in patients with pre-existing obesity and /or type 2 diabetes mellitus and influence on their treatment as also mortality. During the COVID-19 pandemic, it was observed that disease severity is often correlated with existing comorbidities, mainly in older obese male patients. SARS-CoV-2-infected patients with chronic diseases required hospitalisation more often and their overall prognosis is worse. The following review describes the impact of obesity and diabetes on the SARS-CoV-2 infection course and mortality risk. Diabetes and obesity have a multifactorial impact on the risk of SARS-CoV-2 virus infection, as well as on the nature and dynamics of the development of the infection. In turn, the presence of these diseases significantly increased the risk of requiring intensified treatment, complications and ultimately death. Limited access to medical care systems due to the pandemic and the impact on everyday activities made it even more difficult to control diabetes and obesity, leading to the deterioration of patient’s condition and the occurrence of new cases of disease. Therefore, it is necessary not only to appropriately modify treatment of those already infected, but also to use appropriate prevention to reduce the number of potential high-risk patients.
Citizen Science (CS) has been conceptualised as research where the public contributes to science, with the outcome being new knowledge. We discuss CS projects in schools in Finland and Poland addressing the challenges of linguistic diversity. In this project, we have been committed to Co-creative CS (CCS), where non-professional participants are involved in all stages of the research process and the control over the process is shared. First, we review the state of the art in CS research on multilingualism with a focus on CCS, schools and the youth. Then the highlights and challenges of our learning journey are discussed through experiences of co-designing the projects and the choices made by various participants during the research process. The main insight has been to add the dimension of engagement and social activism to the central outcomes for CCS projects in schools. Thus, we envision CCS not only as science education increasing the youth's capacity to contribute to the knowledge economy, but rather as a tool for connecting academics with the public for co-creating new pathways to engagement and social activism.
BACKGROUND:Efficient dual antiplatelet therapy is crucial in reducing adverse cardiovascular events in patients with acute coronary syndrome (ACS). Comparative effectiveness between clopidogrel, prasugrel, and ticagrelor remains unclear in real-world settings. AIMS:The objective was to evaluate one-year clinical outcomes in ACS patients treated with clopidogrel, prasugrel, or ticagrelor using data from the Polish Registry of Acute Coronary Syndromes (PL-ACS). MATERIAL AND METHODS:This retrospective cohort study analyzed 381 278 ACS patients from the PL-ACS registry from 2009 to 2022, who were treated with clopidogrel, prasugrel, or ticagrelor during hospitalization with a 12-month consistent regimen. The primary outcome was one-year all-cause mortality. Secondary outcomes included a composite of death, myocardial infarction, or stroke, and the net clinical outcome, a composite of all-cause death, myocardial infarction, stroke, and bleeding. Propensity score matching was applied to reduce confounding factors. Cox proportional hazards models were used for analysis. RESULTS:Of 381 278 ACS patients, 332 338 (87.2%) were treated with clopidogrel, 5312 (1.4%) with prasugrel, and 43 628 (11.4%) with ticagrelor. After propensity score matching, prasugrel and ticagrelor reduced mortality compared with clopidogrel (hazard ratios 1.69 and 1.72, respectively; P <0.0001). Ticagrelor also showed superior net clinical outcomes compared with both prasugrel and clopidogrel. CONCLUSIONS:This large-scale study confirms better clinical outcomes of dual antiplatelet therapy with prasugrel or ticagrelor compared to clopidogrel in ACS, with ticagrelor demonstrating superiority over prasugrel in terms of net clinical outcome. Despite the high clopidogrel usage rate in Poland, these findings support the preference for ticagrelor or prasugrel in ACS.
BACKGROUND:As a result of increased life expectancy, the number of octa- and nonagenarians presenting with myocardial infarction is on the rise. These patients are often underrepresented in clinical trials. The aim of this study was to compare the presentation and outcomes of ST-elevation (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) in patients older than 80 years. METHODS:This retrospective study included 14758 patients above 80 years of age hospitalized with STEMI or NSTEMI who were selected from the Polish Registry of Acute Coronary Syndromes using propensity score matching (two equal size groups). RESULTS:Patients with STEMI were more likely to undergo coronary angiography (87.80% vs. 77,03%) and revascularization (80.50% vs. 54.26%); in STEMI the culprit lesion was more likely to be located in left anterior descending artery (LAD) (31.76% vs. 44.43%) or right coronary artery (RCA) (18.41% vs. 35.29%), and NSTEMI more likely to be located in left main (4.59% vs. 1.76%) or other native artery (23.3% vs. 6.02%). Elderly patients with STEMI had higher all-cause mortality at 30-days (19.62% vs. 14.51%) and 1-year (32.00% vs. 29.54%). The difference was highly influenced by initial in-hospital mortality (17.96% vs. 12.48%). Among hospital survivors there was no difference in 30-days mortality and 1-year mortality was higher for NSTEMI hospital survivors (17.06% vs. 14.04%). CONCLUSIONS:In patients older than 80 years of age with similar baseline characteristics, STEMI and NSTEMI had different presentation, outcomes and required different treatment strategy. ST-elevation patients had higher in-hospital mortality and NSTEMI patients had higher post-hospital mortality after 1 year.
