New evidence on the management of Lewy body dementia

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordNote that the article title of the accepted author manuscript is different to that of the final published version.Dementia with Lewy bodies and Parkinson’s disease dementia, jointly known as Lewy body dementia (LBD), are common neurodegenerative conditions. Patients with LBD present with a wide range of cognitive, neuropsychiatric, sleep, motor, and autonomic symptoms. The expression of these varies between individual patients, and over time. Treatments may benefit one symptom, but at the expense of worsening another, making management difficult. Often symptoms are managed in isolation and by different specialists, which undermines high quality care. Clinical trials and meta-analyses now provide an improved evidence base for the treatment of cognitive, neuropsychiatric and motor symptoms in LBD, in addition to which expert consensus opinion supports the application of treatments from related conditions such as Parkinson’s disease (PD) for the management of, for example, autonomic symptoms. There remain however clear evidence gaps and there is a high need for future clinical trials focused on specific symptoms in LBD.National Institute for Health Research (NIHR

Исследование влияния ионизирующего излучения высокоэнергетических ионов гелия на процессы формирования протон-проводящих свойств полимерных фторсодержащих функциональных трековых мембран

Объект исследования-полимерная пленка ПВДФ и прививаемый мономер–стирол, обладающий сшивающими свойствами при модификации. Цель работы–синтез протон-проводящих мембран путем модифицирования пленок ПВДФ сульфированным полистиролом и установление влияния наполнителей на их транспортные и физико-химические свойства. В процессе проводились теоретические и экспериментальные работы по радиационно-химической полимеризации стирола в матрицу ПВДФ с последующим сульфированием полимерного композита, по определению обменной емкости и протонной проводимости мембран. В результате получена ППМ путем матричной полимеризации ПВДФ ионизующимся мономером. Результаты представляют интерес для понимания процессов матричной полимеризации ионизующихся мономеров и могут являться основой для создания полимерных сисThe object of study-polymer film PVDF and grafting monomer is styrene, having crosslinking properties when enchanted. Purpose–synthesis of proton-conducting membranes by the modification of the PVDF films of sulfonated polystyrene and evaluation of the influence of fillers on the transport and their physico-chemical properties. The process was carried out work on radiation-chemical polymerization of styrene in a matrix of PVDF with subsequent by sulfonation polymer composite, by definition, exchange capacity and proton conductivity of the membranes. The result is PCM by matrix polymerization of PVDF ionizable monomer. The results are of interest for understanding the processes matrix polymerization of ionizable monomers and may be the basis for the creation of polymer systems

Characteristics of EGRET Blazars in the VLBA Imaging and Polarimetry Survey (VIPS)

We examine the radio properties of EGRET-detected blazars observed as part of the VLBA Imaging and Polarimetry Survey (VIPS). VIPS has a flux limit roughly an order of magnitude below the MOJAVE survey and most other samples that have been used to study the properties of EGRET blazars. At lower flux levels, radio flux density does not directly correlate with gamma-ray flux density. We do find that the EGRET-detected blazars tend to have higher brightness temperatures, greater core fractions, and possibly larger than average jet opening angles. A weak correlation is also found with jet length and with polarization. All of the well-established trends can be explained by systematically larger Doppler factors in the gamma-ray loud blazars, consistent with the measurements of higher apparent velocities found in monitoring programs carried out at radio frequencies above 10 GHz.Comment: 20 pages, 7 figures, accepted to Ap

A web-based normative calculator for the uniform data set (UDS) neuropsychological test battery

Introduction: With the recent publication of new criteria for the diagnosis of preclinical Alzheimer's disease (AD), there is a need for neuropsychological tools that take premorbid functioning into account in order to detect subtle cognitive decline. Using demographic adjustments is one method for increasing the sensitivity of commonly used measures. We sought to provide a useful online z-score calculator that yields estimates of percentile ranges and adjusts individual performance based on sex, age and/or education for each of the neuropsychological tests of the National Alzheimer's Coordinating Center Uniform Data Set (NACC, UDS). In addition, we aimed to provide an easily accessible method of creating norms for other clinical researchers for their own, unique data sets. Methods: Data from 3,268 clinically cognitively-normal older UDS subjects from a cohort reported by Weintraub and colleagues (2009) were included. For all neuropsychological tests, z-scores were estimated by subtracting the raw score from the predicted mean and then dividing this difference score by the root mean squared error term (RMSE) for a given linear regression model. Results: For each neuropsychological test, an estimated z-score was calculated for any raw score based on five different models that adjust for the demographic predictors of SEX, AGE and EDUCATION, either concurrently, individually or without covariates. The interactive online calculator allows the entry of a raw score and provides five corresponding estimated z-scores based on predictions from each corresponding linear regression model. The calculator produces percentile ranks and graphical output. Conclusions: An interactive, regression-based, normative score online calculator was created to serve as an additional resource for UDS clinical researchers, especially in guiding interpretation of individual performances that appear to fall in borderline realms and may be of particular utility for operationalizing subtle cognitive impairment present according to the newly proposed criteria for Stage 3 preclinical Alzheimer's disease

An Innovative Interactive Modeling Tool to Analyze Scenario-Based Physician Workforce Supply and Demand

Effective physician workforce management requires that the various organizations comprising the House of Medicine be able to assess their current and future workforce supply. This information has direct relevance to funding of graduate medical education. We describe a dynamic modeling tool that examines how individual factors and practice variables can be used to measure and forecast the supply and demand for existing and new physician services. The system we describe, while built to analyze the pathologist workforce, is sufficiently broad and robust for use in any medical specialty. Our design provides a computer-based software model populated with data from surveys and best estimates by specialty experts about current and new activities in the scope of practice. The model describes the steps needed and data required for analysis of supply and demand. Our modeling tool allows educators and policy makers, in addition to physician specialty organizations, to assess how various factors may affect demand (and supply) of current and emerging services. Examples of factors evaluated include types of professional services (3 categories with 16 subcategories), service locations, elements related to the Patient Protection and Affordable Care Act, new technologies, aging population, and changing roles in capitated, value-based, and team-based systems of care. The model also helps identify where physicians in a given specialty will likely need to assume new roles, develop new expertise, and become more efficient in practice to accommodate new value-based payment models

Cognitive decline in Parkinson disease

This is the author accepted manuscript. the final version is available from Nature Research via the DOI in this recordDementia is a frequent problem encountered in advanced stages of Parkinson disease (PD). In recent years, research has focused on the pre-dementia stages of cognitive impairment in PD, including mild cognitive impairment (MCI). Several longitudinal studies have shown that MCI is a harbinger of dementia in PD, although the course is variable, and stabilization of cognition — or even reversal to normal cognition — is not uncommon. In addition to limbic and cortical spread of Lewy pathology, several other mechanisms are likely to contribute to cognitive decline in PD, and a variety of biomarker studies, some using novel structural and functional imaging techniques, have documented in vivo brain changes associated with cognitive impairment. The evidence consistently suggests that low cerebrospinal fluid levels of amyloid-β42, a marker of comorbid Alzheimer disease (AD), predict future cognitive decline and dementia in PD. Emerging genetic evidence indicates that in addition to the APOE*ε4 allele (an established risk factor for AD), GBA mutations and SCNA mutations and triplications are associated with cognitive decline in PD, whereas the findings are mixed for MAPT polymorphisms. Cognitive enhancing medications have some effect in PD dementia, but no convincing evidence that progression from MCI to dementia can be delayed or prevented is available, although cognitive training has shown promising results.National Institute for Health Research (NIHR)Royal SocietyWolfson Foundatio

The psychosis spectrum in Parkinson disease

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this recordIn 2007, the clinical and research profile of illusions, hallucinations, delusions and related symptoms in Parkinson disease (PD) was raised with the publication of a consensus definition of PD psychosis. Symptoms that were previously deemed benign and clinically insignificant were incorporated into a continuum of severity, leading to the rapid expansion of literature focusing on clinical aspects, mechanisms and treatment. Here, we review this literature and the evolving view of PD psychosis. Key topics include the prospective risk of dementia in individuals with PD psychosis, and the causal and modifying effects of PD medication. We discuss recent developments, including recognition of an increase in the prevalence of psychosis with disease duration, addition of new visual symptoms to the psychosis continuum, and identification of frontal executive, visual perceptual and memory dysfunction at different disease stages. In addition, we highlight novel risk factors-for example, autonomic dysfunction-that have emerged from prospective studies, structural MRI evidence of frontal, parietal, occipital and hippocampal involvement, and approval of pimavanserin for the treatment of PD psychosis. The accumulating evidence raises novel questions and directions for future research to explore the clinical management and biomarker potential of PD psychosis.National Institute for Health Research (NIHR

The Robinson Gravitational Wave Background Telescope (BICEP): a bolometric large angular scale CMB polarimeter

The Robinson Telescope (BICEP) is a ground-based millimeter-wave bolometric array designed to study the polarization of the cosmic microwave background radiation (CMB) and galactic foreground emission. Such measurements probe the energy scale of the inflationary epoch, tighten constraints on cosmological parameters, and verify our current understanding of CMB physics. Robinson consists of a 250-mm aperture refractive telescope that provides an instantaneous field-of-view of 17 degrees with angular resolution of 55 and 37 arcminutes at 100 GHz and 150 GHz, respectively. Forty-nine pair of polarization-sensitive bolometers are cooled to 250 mK using a 4He/3He/3He sorption fridge system, and coupled to incoming radiation via corrugated feed horns. The all-refractive optics is cooled to 4 K to minimize polarization systematics and instrument loading. The fully steerable 3-axis mount is capable of continuous boresight rotation or azimuth scanning at speeds up to 5 deg/s. Robinson has begun its first season of observation at the South Pole. Given the measured performance of the instrument along with the excellent observing environment, Robinson will measure the E-mode polarization with high sensitivity, and probe for the B-modes to unprecedented depths. In this paper we discuss aspects of the instrument design and their scientific motivations, scanning and operational strategies, and the results of initial testing and observations.Comment: 18 pages, 11 figures. To appear in Millimeter and Submillimeter Detectors and Instrumentation for Astronomy III, Proceedings of SPIE, 6275, 200

Near-Infrared Photometry and Radio Continuum Study of the Massive Star Forming Regions IRAS 21413+5442 and IRAS 21407+5441

IRAS 21413+5442 and IRAS 21407+5441 are two massive star forming regions of high luminosity, likely associated with each other. Near-infrared photometry on these two IRAS sources was performed at UKIRT using the UFTI under excellent seeing conditions yielding an angular resolution of $\sim$ 0.5 arcsec. Our results reveal details of stellar content to a completeness limit (90%) of J = 18.5, H = 18.0, and K = 17.5 mag in the two regions. In IRAS 21413+5442, we identify a late O type star, having large (H-K) color, to be near the centre of the CO jets observed by earlier authors. The UKIRT images reveal in IRAS 21407+5441, a faint but clear compact HII region around a central high - intermediate mass star cluster. We have detected a number of sources with large (H-K) color which are not detected in J band. We also present the GMRT radio continuum map at 1.28 GHz covering the entire region surrounding the two star forming clouds. The radio continuum fluxes are used to estimate the properties of HII regions which seem to support our near-IR photometric results. Based on our radio continuum map and the archival MSX 8.2 $\mu$m image, we show that the two IRAS sources likely belong to the same parent molecular cloud and conjecture that a high mass star of large IR colors, present in between the two sources, might have triggered star formation in this region. However one can not rule out the alternative possibility that Star A could be a nearby foreground star.Comment: 12 pages, 7 figures, accepted for publication in MNRA

Measuring cognition and function in the preclinical stage of Alzheimer\u27s disease

© 2018 The Authors The Alzheimer\u27s Association\u27s Research Roundtable met in November 2016 to explore how best to measure changes in cognition and function in the preclinical stage of Alzheimer\u27s disease. This review will cover the tools and instruments currently available to identify populations for prevention trials, and measure subtle disease progression in the earliest stages of Alzheimer\u27s disease, and will include discussions of suitable cognitive, behavioral, functional, composite, and biological endpoints for prevention trials. Current prevention trials are reviewed including TOMMOROW, Alzheimer\u27s Prevention Initiative Autosomal Dominant Alzheimer\u27s Disease Trial, the Alzheimer\u27s Prevention Initiative Generation Study, and the Anti-Amyloid Treatment in Asymptomatic Alzheimer\u27s to compare current approaches and tools that are being developed