Objective: Childhood obesity, affected by dietary choices, increases cardiovascular risk.Obesity is associated with inflammation and altered glucose, iron and lipid metabolism. This study explores connections between dietary habits, plasma fatty acid profile, cardiovascular risk factors and childhood obesity. Methods: We conducted a case-control study including 20 children and adolescents with obesity and 20 controls. Anthropometric parameters and food frequency questionnaires were registered. Glucose metabolism, iron parameters, lipid profile, fatty acids profile, and lipoprotein-associated phospholipase A 2 (Lp-PLA2 ), cholesteryl ester transfer protein and paraoxonase 1 (PON 1) activities were evaluated. Correlation, regression and mediation analyses were performed. Results: The group with obesity consumed more bakery products and less cereals, and presented higher myristic, palmitoleic, margaric and gamma-linolenic acids, along with lower linoleic, arachidic, gadoleic, eicosatrienoic and eicosapentaenoic (EPA) acids (p<0.05). They also exhibited altered glucose metabolism, a more atherogenic lipid profile, higher Lp-PLA2 and lower PON 1 activities (p<0.05). Consumption of several food groups correlated with metabolic alterations. Different correlations between pro-inflammatory, antiinflammatory and obesity-related fatty acids, and cardiometabolic biomarkers were found, including: myristic acid with Lp-PLA2 (r=0.32, p<0.05), EPA acid with hs-CRP (r=−0.36, p<0.05) and gadoleic acid with PON1 (r=0.39, p<0.05). Mediation analyses revealed fatty acids and cardiometabolic markers as mediators of the association between dietary habits and obesity. Conclusion Children and adolescents with obesity presented disrupted glucose and lipid metabolism, vascular inflammation, attenuated antioxidant function and altered fatty acid composition. Direct and indirect associations between dietary habits, fatty acids, cardiometabolic markers and the presence of obesity were found.

Objective: Mobility limitations and falls are common in people with Parkinson’s disease (PwP). Compared with exercise alone, a tailored, multidomain intervention has the potential to be more effective in improving mobility safety and preventing falls. This study aimed to explore the feasibility and potential effectiveness of a multidomain fall prevention intervention (Integrate) designed for PwP who experience frequent falls. Methods: The home-based intervention was delivered over a span of 6 months by occupational therapists and physiotherapists. The personalized intervention included home fall hazard reduction, exercise, and safer mobility behavior training. The participants received 8 to 12 home visits and were supported by care-partners (when necessary) to participate in the intervention. Results: Twenty-nine people (recruitment rate: 49%; drop-out rate: 10%) with moderate to advanced Parkinson’s disease, a history of recurrent falls, and mild to moderate cognitive impairment participated in the study, with 26 people completing the study. A moderate-to-high adherence to the intervention was observed, and there were no adverse events related to the intervention. Twenty-one (81%) participants met or exceeded their safer mobility goal based on the Goal Attainment Scale. The participants exhibited a median 1.0-point clinically meaningful improvement according to the Short Physical Performance Battery. An exploratory analysis revealed that fall rates were reduced by almost 50% in the 6-month follow-up period (incidence rate ratio: 0.51; 95% confidence interval 0.28–0.92). Conclusion A multidomain occupational therapy and physiotherapy intervention for PwP experiencing recurrent falls was feasible and appeared to improve mobility safety. A randomized trial powered to detect the effects of the intervention on falls and mobility is warranted.

Background: and Purpose Limited evidence exists on the effectiveness of endovascular treatment (EVT) for acute posterior circulation tandem lesion (PCTL). This study aimed to explore the role of extracranial vertebral artery (VA) stenting in patients with PCTL stroke undergoing EVT. Methods: Individual patient data were pooled from the BASILAR (EVT for Acute Basilar Artery Occlusion Study) and PERSIST (Posterior Circulation Ischemic Stroke) registries. Patients with PCTLs who underwent EVT were included in the present cohort and divided into the stenting and nonstenting groups based on the placement of extracranial VA stents. The primary efficacy outcome was the modified Rankin Scale (mRS) scores at 90 days and 1 year. Safety outcomes included 24-hour symptomatic intracranial hemorrhage (sICH) and all-cause mortality at 90 days and 1 year post-surgery. Results: A combined dataset of 1,320 patients with posterior circulation artery occlusion, including 263 (19.9%) with tandem lesions, of whom 217 (median age, 65 years; 82.9% male) met the inclusion criteria for the analysis. The stenting group had 84 (38.7%) patients, while the non-stenting group had 133 (61.3%). After adjustment for the potential confounders, extracranial VA stenting was associated with favorable shifts in mRS scores at both 90 days (adjusted common odds ratio [OR], 2.30; 95% confidence interval [CI], 1.23–4.28; P<0.01) and 1 year (adjusted OR [aOR], 2.04; 95% CI [1.05–3.97]; P=0.04), along with lower rate of mortality at both 90 days (aOR, 0.45; 95% CI [0.21–0.93]; P=0.01) and 1 year (aOR, 0.36; 95% CI [0.16–0.79]; P=0.01), with no significant difference in sICH incidence (aOR, 0.35; 95% CI [0.06–1.98]; P=0.24). Conclusion Extracranial VA stenting during EVT may improve functional outcomes and reduce mortality in patients with PCTL strokes.

Background: and Purpose Antiplatelets are often used before direct oral anticoagulant (DOACs) initiation after an acute ischemic stroke related to atrial fibrillation (AF), but the evidence is weak. Here, we explored the risks and benefits of this approach. Methods: A post-hoc analysis of ELAN (Early versus Late Initiation of Direct Oral Anticoagulants in Post-ischemic Stroke Patients with Atrial Fibrillation) trial data (NCT03148457) was conducted to compare the risk of recurrent ischemic stroke, systemic embolism, major bleeding (extracranial or intracranial hemorrhage [ICH]), and vascular death within 30 days (as a composite and as individual outcomes) in participants treated with and without antiplatelets before DOAC initiation after an AF-associated ischemic stroke. We used both logistic and cause-specific Cox proportional hazards regression in inverse probability of treatment weighted models to account for confounding. We calculated the net benefit of antiplatelet use by subtracting the weighted rate of excess bleeding events attributable to antiplatelets from the rate of excess ischemic events possibly prevented by antiplatelets. Results: Among 2,013 participants (median age 77 years, 45.5% female), 1,090 (54.1%) used antiplatelets, and 70 (3.5%) experienced the composite outcome. Antiplatelet use was not associated with the composite outcome (inverse probability of treatment weighted odds ratio [ORweighted] 1.06, 95% confidence interval [CI] 0.66–1.72; inverse probability of treatment weighted hazard ratio [HRweighted] 1.06, 95% CI 0.65–1.72), but showed a lower risk of ischemic stroke recurrence (ORweighted 0.58 [0.30–1.08], HRweighted 0.57 [0.30–1.10]), and a higher risk of major bleeding (ORweighted 1.76 [0.56–6.63], HRweighted 1.88 [0.56–6.39]). Its net benefit was +0.57 (95% CI -1.25 to +2.34) to +0.30 (-1.82 to +2.27) weighted events/100 person-months for ICH weights 1.5 to 3.1. Conclusion Following an AF-associated ischemic stroke, we found a lower risk of recurrence and no signs of net harm with antiplatelet use before DOAC initiation, despite an increased risk of bleeding.

Objective: Childhood obesity, affected by dietary choices, increases cardiovascular risk.Obesity is associated with inflammation and altered glucose, iron and lipid metabolism. This study explores connections between dietary habits, plasma fatty acid profile, cardiovascular risk factors and childhood obesity. Methods: We conducted a case-control study including 20 children and adolescents with obesity and 20 controls. Anthropometric parameters and food frequency questionnaires were registered. Glucose metabolism, iron parameters, lipid profile, fatty acids profile, and lipoprotein-associated phospholipase A 2 (Lp-PLA2 ), cholesteryl ester transfer protein and paraoxonase 1 (PON 1) activities were evaluated. Correlation, regression and mediation analyses were performed. Results: The group with obesity consumed more bakery products and less cereals, and presented higher myristic, palmitoleic, margaric and gamma-linolenic acids, along with lower linoleic, arachidic, gadoleic, eicosatrienoic and eicosapentaenoic (EPA) acids (p<0.05). They also exhibited altered glucose metabolism, a more atherogenic lipid profile, higher Lp-PLA2 and lower PON 1 activities (p<0.05). Consumption of several food groups correlated with metabolic alterations. Different correlations between pro-inflammatory, antiinflammatory and obesity-related fatty acids, and cardiometabolic biomarkers were found, including: myristic acid with Lp-PLA2 (r=0.32, p<0.05), EPA acid with hs-CRP (r=−0.36, p<0.05) and gadoleic acid with PON1 (r=0.39, p<0.05). Mediation analyses revealed fatty acids and cardiometabolic markers as mediators of the association between dietary habits and obesity. Conclusion Children and adolescents with obesity presented disrupted glucose and lipid metabolism, vascular inflammation, attenuated antioxidant function and altered fatty acid composition. Direct and indirect associations between dietary habits, fatty acids, cardiometabolic markers and the presence of obesity were found.

Objective: Mobility limitations and falls are common in people with Parkinson’s disease (PwP). Compared with exercise alone, a tailored, multidomain intervention has the potential to be more effective in improving mobility safety and preventing falls. This study aimed to explore the feasibility and potential effectiveness of a multidomain fall prevention intervention (Integrate) designed for PwP who experience frequent falls. Methods: The home-based intervention was delivered over a span of 6 months by occupational therapists and physiotherapists. The personalized intervention included home fall hazard reduction, exercise, and safer mobility behavior training. The participants received 8 to 12 home visits and were supported by care-partners (when necessary) to participate in the intervention. Results: Twenty-nine people (recruitment rate: 49%; drop-out rate: 10%) with moderate to advanced Parkinson’s disease, a history of recurrent falls, and mild to moderate cognitive impairment participated in the study, with 26 people completing the study. A moderate-to-high adherence to the intervention was observed, and there were no adverse events related to the intervention. Twenty-one (81%) participants met or exceeded their safer mobility goal based on the Goal Attainment Scale. The participants exhibited a median 1.0-point clinically meaningful improvement according to the Short Physical Performance Battery. An exploratory analysis revealed that fall rates were reduced by almost 50% in the 6-month follow-up period (incidence rate ratio: 0.51; 95% confidence interval 0.28–0.92). Conclusion A multidomain occupational therapy and physiotherapy intervention for PwP experiencing recurrent falls was feasible and appeared to improve mobility safety. A randomized trial powered to detect the effects of the intervention on falls and mobility is warranted.