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Background Measurement of beta-amyloid (Aβ) and phosphorylated tau (p-tau) levels offers the potential for early detection of neurocognitive impairment. Still, the probability of developing a clinical syndrome in the presence of these protein changes (A+ and T+) remains unclear. By performing a systematic review and meta-analysis, we investigated the risk of mild cognitive impairment (MCI) or dementia in the non-demented population with A+ and A- alone and in combination with T+ and T- as confirmed by PET or cerebrospinal fluid examination. Methods A systematic search of prospective and retrospective studies investigating the association of Aβ and p-tau with cognitive decline was performed in three databases (MEDLINE via PubMed, EMBASE, and CENTRAL) on January 9, 2024. The risk of bias was assessed using the Cochrane QUIPS tool. Odds ratios (OR) and Hazard Ratios (HR) were pooled using a random-effects model. The effect of neurodegeneration was not studied due to its non-specific nature. Results A total of 18,162 records were found, and at the end of the selection process, data from 36 cohorts were pooled ( n = 7,793). Compared to the unexposed group, the odds ratio (OR) for conversion to dementia in A+ MCI patients was 5.18 [95% CI 3.93; 6.81]. In A+ CU subjects, the OR for conversion to MCI or dementia was 5.79 [95% CI 2.88; 11.64]. Cerebrospinal fluid Aβ42 or Aβ42/40 analysis and amyloid PET imaging showed consistent results. The OR for conversion in A+T+ MCI subjects (11.60 [95% CI 7.96; 16.91]) was significantly higher than in A+T- subjects (2.73 [95% CI 1.65; 4.52]). The OR for A-T+ MCI subjects was non-significant (1.47 [95% CI 0.55; 3.92]). CU subjects with A+T+ status had a significantly higher OR for conversion (13.46 [95% CI 3.69; 49.11]) than A+T- subjects (2.04 [95% CI 0.70; 5.97]). Meta-regression showed that the ORs for Aβ exposure decreased with age in MCI. (beta = -0.04 [95% CI -0.03 to -0.083]). Conclusions Identifying Aβ-positive individuals, irrespective of the measurement technique employed (CSF or PET), enables the detection of the most at-risk population before disease onset, or at least at a mild stage. The inclusion of tau status in addition to Aβ, especially in A+T+ cases, further refines the risk assessment. Notably, the higher odds ratio associated with Aβ decreases with age. Trial registration The study was registered in PROSPERO (ID: CRD42021288100).

Stigma towards people with mental health problems is a growing issue across the world, to which healthcare providers might contribute. The aim of the present study was to explore psychiatrists' attitudes towards their patients and link them to psychosocial and professional factors. An online questionnaire was used to approach the in- and outpatient psychiatric services across Hungary. A total of 211 trainees and specialists in adult and child psychiatry participated in our study. Their overall stigmatizing attitudes were measured, with focus on attitude, disclosure and help-seeking, and social distance dimensions by using the self-report Opening Minds Stigma Scale for Health Care Providers (OMS-HC). Multiple linear regression analyses were performed to elucidate the dimensions of stigma and its association with sociodemographic, professional and personal traits. Stigmatizing attitudes of close colleagues towards patients were statistically significant predictors of higher scores on the attitude [B = 0.235 (0.168-0.858), p = 0.004], the disclosure and help-seeking subscales [B = 0.169 (0.038-0.908), p = 0.033], and the total score of the OMS-HC [B = 0.191 (0.188-1.843), p = 0.016]. Psychiatrists who had already sought help for their own problems had lower scores on the disclosure and help-seeking subscale [B = 0.202 (0.248-1.925), p = 0.011]. The overall stigmatizing attitude was predicted by the openness to participate in case discussion, supervision or Balint groups [B = 0.166 (0.178-5.886), p = 0.037] besides the more favorable attitudes of their psychiatrist colleagues [B = 0.191 (0.188-1.843), p = 0.016]. The favorable attitudes of psychiatrists are associated with their own experiences with any kind of psychiatric condition, previous help-seeking behavior and the opportunity to work together with fellow psychiatrists, whose attitudes are less stigmatizing. The perception of fellow colleagues' attitudes towards patients and the openness to case discussion, supervision and Balint groups were the main two factors that affected the overall attitudes towards patients; therefore, these should be considered when tailoring anti-stigma interventions for psychiatrists.

Background Dementia preventive interventions targeting multiple modifiable risk factors are a promising approach. However, the impact of modifiable risk factors in the presence of beta-amyloid or phosphorylated-tau (p-tau) pathology is unclear. Methods The objective of the study was to examine the role of modifiable risk factors (vascular factors, depression, and smoking) in the progression to mild cognitive impairment (MCI) or dementia among 434 cognitively unimpaired (CU) and 611 individuals with MCI from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Vascular risk factors were summarized with the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) score, dichotomized into higher versus lower risk. Depression and smoking (yes/no) were categorised according to medical history or current symptoms. Analyses were stratified by beta-amyloid negative (A-) and positive (A +), p-tau negative (T-) and positive (T +), or beta-amyloid and p-tau negative (A-T-) and positive (A + T +) biomarker status. Cox proportional hazard models were adjusted for age, sex, education, baseline MMSE score, baseline hippocampal volume and ApoE4 carrier status. Results Higher CAIDE score was associated with increased risk of progression to all-cause dementia in most MCI subgroups: adjusted hazard ratios (aHR) [95% CI] were 3.1 [1.43; 6.53] in the A- subgroup, 1.7 [1.20–2.27] in T + , 2.6 [1.06–6.59] in A-T-, and 1.6 [1.15–2.22] in the A + T + subgroup. Smoking (yes/no) was associated with increased dementia aHR in the A + MCI subgroup: 1.6 [1.07–2.34]. Depression increased dementia aHR in the T + MCI subgroup: 1.5 [1.06–2.02]. No significant associations were found in the CU biomarker subgroups. Conclusion Addressing modifiable risk factors carries an important potential for reducing the risk of dementia even after the onset of Alzheimer's pathology. Knowledge of biomarker status can further optimize prevention strategies.

Objective Methods of cognitive measurements in multiple sclerosis (MS) are not standardized. We aimed to identify the prevalence of cognitive domain‐specific impairment (DSI) in MS by using subtests of the Brief Repeatable Battery of Neuropsychological Tests (BRB‐N) with analyzing different cutoff values. Methods The systematic review and meta‐analysis were registered on PROSPERO (ID: CRD42021287004). The systematic literature search was performed via PubMed, Embase, and CENTRAL on 24 October 2021. Inclusion criteria were adults of different MS subtypes (CIS, RRMS, PPMS, and SPMS) with the condition of distinct DSI measured by BRB‐N. Pediatric MS, computerized versions of BRB‐N, and patients receiving steroids were excluded. Primary outcome was pooled prevalence rates of impaired patients within each cutoff and MS subtype, with 95% confidence interval, I‐squared statistics for heterogeneity, and chi‐squared test for subgroup differences. Risk of bias was assessed using the “JBI Quality Assessment Tool for Prevalence Studies.” Results In 48 eligible observational studies (n = 3431 patients), the three most prevalent thresholds were the 2.0 SD and 1.5 SD below the mean of normative values, and the score below the fifth percentile of the normative values. A progressively increasing worsening of the overall DSI was observed from CIS, moving toward RRMS, PPMS, and SPMS. Interpretation Cognitive impairment is observed in all MS phenotypes, with varying degrees. Due to several potential influencing factors, our comprehensive literature review has not revealed consistent findings, and we, therefore, recommend considering a more sophisticated, “individual referencing” approach, acknowledging the diverse clinical and sociodemographic characteristics among populations and disparities in cognitive testing.

Evidence suggests that depressive symptomatology is a consequence of network dysfunction rather than lesion pathology. We studied whole-brain functional connectivity using a Minimum Spanning Tree as a graph-theoretical approach. Furthermore, we examined functional connectivity in the Default Mode Network, the Frontolimbic Network (FLN), the Salience Network, and the Cognitive Control Network. All 183 elderly subjects underwent a comprehensive neuropsychological evaluation and a 3 Tesla brain MRI scan. To assess the potential presence of depressive symptoms, the 13-item version of the Beck Depression Inventory (BDI) or the Geriatric Depression Scale (GDS) was utilized. Participants were assigned into three groups based on their cognitive status: amnestic mild cognitive impairment (MCI), non-amnestic MCI, and healthy controls. Regarding affective symptoms, subjects were categorized into depressed and non-depressed groups. An increased mean eccentricity and network diameter were found in patients with depressive symptoms relative to non-depressed ones, and both measures showed correlations with depressive symptom severity. In patients with depressive symptoms, a functional hypoconnectivity was detected between the Anterior Cingulate Cortex (ACC) and the right amygdala in the FLN, which impairment correlated with depressive symptom severity. While no structural difference was found in subjects with depressive symptoms, the volume of the hippocampus and the thickness of the precuneus and the entorhinal cortex were decreased in subjects with MCI, especially in amnestic MCI. The increase in eccentricity and diameter indicates a more path-like functional network configuration that may lead to an impaired functional integration in depression, a possible cause of depressive symptomatology in the elderly.

Homlokzati állványok építéséről, bontásáról, illetve az állványon történő munkavégzésről általában nem a tüzesetekjutnak eszébe a műszaki szakembereknek. A párizsi Notre-Dame 2019. április 15-i pokoli tűzesete azonban más megvilágításba helyezte az esetleges állványtüzek előfordulásának lehetőségét és azok vizsgálatát. A cikk célja, hogy felhívja a tervezők, kivitelezőkés természetesen a beruházok figyelmét, hogy a homlokzati állvány mint építési segédszerkezet-a sok „klasszikus\" balesti forráson túl-milyen veszélyeket rejt magában, nemcsak a rajta dolgozók számára, hanem adott esetben afelállványozott épületben tartózkodó személyekre, illetve magára az épületre is.

Objective Stigma towards people with mental health problems is a growing issue across the world, to which healthcare providers might contribute. The aim of the present study was to explore psychiatrists’ attitudes towards their patients and link them to psychosocial and professional factors. Methods An online questionnaire was used to approach the in- and outpatient psychiatric services across Hungary. A total of 211 trainees and specialists in adult and child psychiatry participated in our study. Their overall stigmatizing attitudes were measured, with focus on attitude, disclosure and help-seeking, and social distance dimensions by using the self-report Opening Minds Stigma Scale for Health Care Providers (OMS-HC). Multiple linear regression analyses were performed to elucidate the dimensions of stigma and its association with sociodemographic, professional and personal traits. Results Stigmatizing attitudes of close colleagues towards patients were statistically significant predictors of higher scores on the attitude [B = 0.235 (0.168–0.858), p = 0.004], the disclosure and help-seeking subscales [B = 0.169 (0.038–0.908), p = 0.033], and the total score of the OMS-HC [B = 0.191 (0.188–1.843), p = 0.016]. Psychiatrists who had already sought help for their own problems had lower scores on the disclosure and help-seeking subscale [B = 0.202 (0.248–1.925), p = 0.011]. The overall stigmatizing attitude was predicted by the openness to participate in case discussion, supervision or Balint groups [B = 0.166 (0.178–5.886), p = 0.037] besides the more favorable attitudes of their psychiatrist colleagues [B = 0.191 (0.188–1.843), p = 0.016]. Conclusions The favorable attitudes of psychiatrists are associated with their own experiences with any kind of psychiatric condition, previous help-seeking behavior and the opportunity to work together with fellow psychiatrists, whose attitudes are less stigmatizing. The perception of fellow colleagues’ attitudes towards patients and the openness to case discussion, supervision and Balint groups were the main two factors that affected the overall attitudes towards patients; therefore, these should be considered when tailoring anti-stigma interventions for psychiatrists.

The paper presents an application of the method of the generator function.The method is used in the analytic investigation of the free vibrations of aparabolic antenna dish, which is considered as a thin shell. For solving thedifferential equation system of the vibration problem, the method of thegenerator function is applied. This method is based on the generalization ofdeterminants and cofactors of quadratic matrices.In an illustrative example the natural frequencies of the paraboloid arecompared with those of a circular plate having the same radius and materialproperties as the paraboloid, and also with those of the circular plateresting on a fictitious elastic foundation.

Forgásparaboloid-héj rezgésvizsgálataÉrtekezésem első részében lapos, szabad peremű forgásparaboloid-héj sajátrezgésének számításával foglalkoztam.Először áttekintettem a vonatkozó szakirodalmat és a kutatásom kiindulásaként a hajlított lapos héjak statikai alapösszefüggéseit.A dinamikai vizsgálathoz a lapos héjak Marguerre-féle diffrenciálegyenlet-rendszerét kiegészítettem a függőleges elmozdulásoknak megfelelő D’Alembert-féle erővel. A vékony, lapos, szabad peremű forgásparaboloid-héj, illetve a gömbsüveghéj rezgéseit leíró parciális differenciálegyenlet-rendszer megoldására egy új analitikus módszert, a képzőfüggvényes eljárást alkalmaztam.A képzőfüggvény alkalmazásának a legfontosabb előnye, hogy az operátormátrix determinánsával képezett karakterisztikus differenciálegyenlet megoldása után az összes ismeretlen függvény deriválással állítható elő, így nem kerülnek a megoldásba formálisan függetlennek látszó további integrálási konstansok. Másik előny, hogy a peremértékekre és peremderiváltakra vonatkozó peremfeltételek közvetlenül a képzőfüggvényre vonatkozó feltételként vehetők figyelembe. Ezt az eljárást Hegedűs (1986) szendvicsgerenda-feladat megoldásán mutatta be.A képzőfüggvényes eljárás alkalmazásával a forgásparaboloid-héj parciális differenciálegyenlet-rendszerében a koordináta-változókat szétválasztva a sugárirányú változóban egy nyolcadrendű közönséges differenciálegyenletre (a karakterisztikus differenciálegyenletre) jutottam, melynek megoldását hatvány- és Bessel-függvények alkotják. A gyűrűirányú viselkedést trigonometrikus függvények írják le. A w lehajlást és az F feszültségfüggvényt a karakterisztikus differenciálegyenlet megoldásából határoztam meg. Értekezésemben szabad peremű szerkezetet vizsgáltam. A differenciálegyenlet-rendszer és a peremfeltételek együttesen egy sajátérték-feladatot tűznek ki. Ennek megoldásával előállítottam a frekvenciaegyenletet a sajátfrekvenciák és a rezgési alakok meghatározásához.A analitikus módszerhez MATLAB programot dolgoztam ki, mellyel példaképpen egy űrszerkezetként alkalmazható tányérantenna rezgéseit határoztam meg. Kiszámítottam a vizsgált forgásparaboloid-héj rezgési sajátértékeit és sajátfrekvenciáit, valamint rezgési elmozdulás-alakjait. Az eredményeket végeselem program segítségével verifikáltam. Ábrázoltam a különböző típusú rezgési elmozdulás-alakokat, valamint metszeteiket. Megmutattam, hogy a forgásparaboloid-héj gyűrűirányú csomóvonalat nem tartalmazó alacsonyabb k móduszaihoz tartozó sajátértékek és lengési karakterisztikus hosszak komplexek, továbbá megadtam a valós értékre váltáshoz tartozó frekvencia-határt is.Az analitikus eljáráson alapuló számítással összehasonlítottam a forgásparaboloid-héj, valamint ennek specializációjával származtatható szabad peremű ágyazatlan körlemez és rugalmasan ágyazott körlemez rezgéseit. A vizsgált három szerkezetfajta különböző móduszaira kapott sajátfrekvenciák összevetésével megállapítható, hogy a forgásparaboloidhéj gyűrűirányú csomóvonalat nem tartalmazó rezgéseinek sajátfrekvenciái az ágyazatlan körlemezével, míg az egy vagy több gyűrűirányú csomóvonalat tartalmazó rezgések frekvenciái a rugalmas ágyazású körlemezével közelíthetők.Vizsgáltam a geometriai jellemzők hatását is a forgásparaboloid-héj sajátfrekvenciáira.A képzőfüggvényes eljárással levezettem a nyírási alakváltozások figyelembevétele mellett is, a lapos forgásparaboloid-héj illetve a gömbsüveg-héj frekvenciaegyenletét. A várakozásnak megfelelően, a nyírási alakváltozásnak csak az igen magas frekvenciáknál van szerepe.