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

Galaxy And Mass Assembly (GAMA): the wavelength dependence of galaxy structure versus redshift and luminosity

We study how the sizes and radial profiles of galaxies vary with wavelength, by fitting Sersic functions simultaneously to imaging in nine optical and near-infrared bands. To quantify the wavelength dependence of effective radius we use the ratio, $\mathcal{R}$, of measurements in two restframe bands. The dependence of Sersic index on wavelength, $\mathcal{N}$, is computed correspondingly. Vulcani et al. (2014) have demonstrated that different galaxy populations present sharply contrasting behaviour in terms of $\mathcal{R}$ and $\mathcal{N}$. Here we study the luminosity dependence of this result. We find that at higher luminosities, early-type galaxies display a more substantial decrease in effective radius with wavelength, whereas late-types present a more pronounced increase in Sersic index. The structural contrast between types thus increases with luminosity. By considering samples at different redshifts, we demonstrate that lower data quality reduces the apparent difference between the main galaxy populations. However, our conclusions remain robust to this effect. We show that accounting for different redshift and luminosity selections partly reconciles the size variation measured by Vulcani et al. with the weaker trends found by other recent studies. Dividing galaxies by visual morphology confirms the behaviour inferred using morphological proxies, although the sample size is greatly reduced. Finally, we demonstrate that varying dust opacity and disc inclination can account for features of the joint distribution of $\mathcal{R}$ and $\mathcal{N}$ for late-type galaxies. However, dust does not appear to explain the highest values of $\mathcal{R}$ and $\mathcal{N}$. The bulge-disc nature of galaxies must also contribute to the wavelength-dependence of their structure

Galaxy and Mass Assembly (GAMA): Morphological transformation of galaxies across the green valley

We explore constraints on the joint photometric and morphological evolution of typical low redshift galaxies as they move from the blue cloud through the green valley and onto the red sequence. We select GAMA survey galaxies with $10.25<{\rm log}(M_*/M_\odot)<10.75$ and $z<0.2$ classified according to their intrinsic $u^*-r^*$ colour. From single component S\'ersic fits, we find that the stellar mass-sensitive $K-$band profiles of red and green galaxy populations are very similar, while $g-$band profiles indicate more disk-like morphologies for the green galaxies: apparent (optical) morphological differences arise primarily from radial mass-to-light ratio variations. Two-component fits show that most green galaxies have significant bulge and disk components and that the blue to red evolution is driven by colour change in the disk. Together, these strongly suggest that galaxies evolve from blue to red through secular disk fading and that a strong bulge is present prior to any decline in star formation. The relative abundance of the green population implies a typical timescale for traversing the green valley $\sim 1-2$~Gyr and is independent of environment, unlike that of the red and blue populations. While environment likely plays a r\^ole in triggering the passage across the green valley, it appears to have little effect on time taken. These results are consistent with a green valley population dominated by (early type) disk galaxies that are insufficiently supplied with gas to maintain previous levels of disk star formation, eventually attaining passive colours. No single event is needed quench their star formation

Characterization of Shewanella oneidensis MtrC: a cell-surface decaheme cytochrome involved in respiratory electron transport to extracellular electron acceptors

MtrC is a decaheme c-type cytochrome associated with the outer cell membrane of Fe(III)-respiring species of the Shewanella genus. It is proposed to play a role in anaerobic respiration by mediating electron transfer to extracellular mineral oxides that can serve as terminal electron acceptors. The present work presents the first spectropotentiometric and voltammetric characterization of MtrC, using protein purified from Shewanella oneidensis MR-1. Potentiometric titrations, monitored by UV–vis absorption and electron paramagnetic resonance (EPR) spectroscopy, reveal that the hemes within MtrC titrate over a broad potential range spanning between approximately +100 and approximately -500 mV (vs. the standard hydrogen electrode). Across this potential window the UV–vis absorption spectra are characteristic of low-spin c-type hemes and the EPR spectra reveal broad, complex features that suggest the presence of magnetically spin-coupled low-spin c-hemes. Non-catalytic protein film voltammetry of MtrC demonstrates reversible electrochemistry over a potential window similar to that disclosed spectroscopically. The voltammetry also allows definition of kinetic properties of MtrC in direct electron exchange with a solid electrode surface and during reduction of a model Fe(III) substrate. Taken together, the data provide quantitative information on the potential domain in which MtrC can operate

Anterior interosseous nerve syndrome: retrospective analysis of 14 patients

Introduction: The anterior interosseous nerve (AIN) is a only motor nerve innervating the deep muscles of the forearm. Its compression is rare. We present a retrospective analysis of 14 patients with an AIN syndrome with a variety of clinical manifestations who underwent operative and conservative treatment. Patients and methods: Fourteen patients (six female, eight male, mean age 48 ± 9 years) were included. In six patients, the right limb was affected, and in eight patients the left limb. Conservative treatment was started for every patient. If no signs of recovery appeared within 3 months, operative exploration was performed. Final assessment was performed between 2 and 9 years after the onset of paralysis (mean duration of follow-up 46 ± 11 months). Patients were examined clinically for return of power, range of motion, pinch and grip strengths. Also the disability of the arm, shoulder, and hand (DASH) score was calculated. Results: Seven of our 14 patients had incomplete AIN palsy with isolated total loss of function of flexor pollicis longus (FPL), five of FPL and flexor digitorum profundus (FDP)1 simultaneously, and two of FDP1. Weakness of FDP2 could be seen in four patients. Pronator teres was paralysed in two patients. Pain in the forearm was present in nine patients. Four patients had predisposing factors. Eight patients treated conservatively exhibited spontaneous recovery from their paralysis during 3-12 months after the onset. In six patients, the AIN was explored 12 weeks after the initial symptoms and released from compressing structures. Thirteen patients showed good limb function. In one patient with poor result a tendon transfer was necessary. The DASH score of patients treated conservatively and operatively presented no significant difference. Conclusion: AIN syndrome can have different clinical manifestations. If no signs of spontaneous recovery appear within 12 weeks, operative treatment should be performed

Galaxy And Mass Assembly (GAMA): mass-size relations of z < 0.1 galaxies subdivided by Sersic index, colour and morphology

We use data from the Galaxy And Mass Assembly (GAMA) survey in the redshift range 0.01 < z < 0.1 (8399 galaxies in g to Ks bands) to derive the stellar mass–half-light radius relations for various divisions of ‘early’- and ‘late’-type samples. We find that the choice of division between early and late (i.e. colour, shape, morphology) is not particularly critical; however, the adopted mass limits and sample selections (i.e. the careful rejection of outliers and use of robust fitting methods) are important. In particular, we note that for samples extending to low stellar mass limits (<10 10 M ⊙ ) the Sérsic index bimodality, evident for high-mass systems, becomes less distinct and no-longer acts as a reliable separator of early- and late-type systems. The final set of stellar mass–half-light radius relations are reported for a variety of galaxy population subsets in 10 bands (ugrizZY JHKs) and are intended to provide a comprehensive low-z benchmark for the many ongoing high-z studies. Exploring the variation of the stellar mass–half-light radius relations with wavelength, we confirm earlier findings that galaxies appear more compact at longer wavelengths albeit at a smaller level than previously noted: at 10 10 M ⊙ both spiral systems and ellipticals show a decrease in size of 13 per cent from g to Ks (which is near linear in log wavelength). Finally, we note that the sizes used in this work are derived from 2D Sérsic light profile fitting (using galfit3), i.e. elliptical semimajor half-light radii, improving on earlier low-z benchmarks based on circular apertures

Galaxy And Mass Assembly (GAMA): mass-size relations of z < 0.1 galaxies subdivided by Sersic index, colour and morphology

We use data from the Galaxy And Mass Assembly (GAMA) survey in the redshift range 0.01 < z < 0.1 (8399 galaxies in g to Ks bands) to derive the stellar mass–half-light radius relations for various divisions of ‘early’- and ‘late’-type samples. We find that the choice of division between early and late (i.e. colour, shape, morphology) is not particularly critical; however, the adopted mass limits and sample selections (i.e. the careful rejection of outliers and use of robust fitting methods) are important. In particular, we note that for samples extending to low stellar mass limits (<10 10 M ⊙ ) the Sérsic index bimodality, evident for high-mass systems, becomes less distinct and no-longer acts as a reliable separator of early- and late-type systems. The final set of stellar mass–half-light radius relations are reported for a variety of galaxy population subsets in 10 bands (ugrizZY JHKs) and are intended to provide a comprehensive low-z benchmark for the many ongoing high-z studies. Exploring the variation of the stellar mass–half-light radius relations with wavelength, we confirm earlier findings that galaxies appear more compact at longer wavelengths albeit at a smaller level than previously noted: at 10 10 M ⊙ both spiral systems and ellipticals show a decrease in size of 13 per cent from g to Ks (which is near linear in log wavelength). Finally, we note that the sizes used in this work are derived from 2D Sérsic light profile fitting (using galfit3), i.e. elliptical semimajor half-light radii, improving on earlier low-z benchmarks based on circular apertures

Infarction in the territory of the anterior cerebral artery: clinical study of 51 patients

<p>Abstract</p> <p>Background</p> <p>Little is known about clinical features and prognosis of patients with ischaemic stroke caused by infarction in the territory of the anterior cerebral artery (ACA). This single centre, retrospective study was conducted with the following objectives: a) to describe the clinical characteristics and short-term outcome of stroke patients with ACA infarction as compared with that of patients with ischaemic stroke due to middle cerebral artery (MCA) and posterior cerebral artery (PCA) infarctions, and b) to identify predictors of ACA stroke.</p> <p>Methods</p> <p>Fifty-one patients with ACA stroke were included in the "Sagrat Cor Hospital of Barcelona Stroke Registry" during a period of 19 years (1986–2004). Data from stroke patients are entered in the stroke registry following a standardized protocol with 161 items regarding demographics, risk factors, clinical features, laboratory and neuroimaging data, complications and outcome. The characteristics of these 51 patients with ACA stroke were compared with those of the 1355 patients with MCA infarctions and 232 patients with PCA infarctions included in the registry.</p> <p>Results</p> <p>Infarctions of the ACA accounted for 1.3% of all cases of stroke (<it>n </it>= 3808) and 1.8% of cerebral infarctions (<it>n </it>= 2704). Stroke subtypes included cardioembolic infarction in 45.1% of patients, atherothrombotic infarction in 29.4%, lacunar infarct in 11.8%, infarct of unknown cause in 11.8% and infarction of unusual aetiology in 2%. In-hospital mortality was 7.8% (<it>n </it>= 4). Only 5 (9.8%) patients were symptom-free at hospital discharge. Speech disturbances (odds ratio [OR] = 0.48) and altered consciousness (OR = 0.31) were independent variables of ACA stroke in comparison with MCA infarction, whereas limb weakness (OR = 9.11), cardioembolism as stroke mechanism (OR = 2.49) and sensory deficit (OR = 0.35) were independent variables associated with ACA stroke in comparison with PCA infarction.</p> <p>Conclusion</p> <p>Cardioembolism is the main cause of brain infarction in the territory of the ACA. Several clinical features are more frequent in stroke patients with ACA infarction than in patients with ischaemic stroke due to infarction in the MCA and PCA territories.</p

Spatially explicit poisoning risk affects survival rates of an obligate scavenger

Obligate scavengers such as vultures provide critical ecosystem services and their populations have undergone severe declines in Asia and Africa. Intentional poisoning is a major threat to vultures in Africa, yet the impact on vulture populations of where poisoned carcasses are positioned is not known. We used re-sightings of 183 African white-backed vultures captured and tagged in two regions of South Africa, some 200 km apart, to estimate spatial differences in relative survival rates across life stages. Juvenile survival rates were similar in the two regions, whilst subadult and adult survival rates differed significantly. Using agent-based modelling, we show that this pattern of relative survival rates is consistent between regions that differ in intensity of poisoning, despite the proximity of the two regions. This may have important consequences for vulture conservation and the targeting of conservation efforts, particularly with regard to the efficacy of “vulture safe zones” around vulture breeding populations

Temporal profile of body temperature in acute ischemic stroke: relation to stroke severity and outcome

BACKGROUND: Pyrexia after stroke (temperature ≥37.5°C) is associated with poor prognosis, but information on timing of body temperature changes and relationship to stroke severity and subtypes varies. METHODS: We recruited patients with acute ischemic stroke, measured stroke severity, stroke subtype and recorded four-hourly tympanic (body) temperature readings from admission to 120 hours after stroke. We sought causes of pyrexia and measured functional outcome at 90 days. We systematically summarised all relevant previous studies. RESULTS: Amongst 44 patients (21 males, mean age 72 years SD 11) with median National Institute of Health Stroke Score (NIHSS) 7 (range 0–28), 14 had total anterior circulation strokes (TACS). On admission all patients, both TACS and non-TACS, were normothermic (median 36.3°C vs 36.5°C, p=0.382 respectively) at median 4 hours (interquartile range, IQR, 2–8) after stroke; admission temperature and NIHSS were not associated (r(2)=0.0, p=0.353). Peak temperature, occurring at 35.5 (IQR 19.0 to 53.8) hours after stroke, was higher in TACS (37.7°C) than non-TACS (37.1°C, p<0.001) and was associated with admission NIHSS (r(2)=0.20, p=0.002). Poor outcome (modified Rankin Scale ≥3) at 90 days was associated with higher admission (36.6°C vs. 36.2°C p=0.031) and peak (37.4°C vs. 37.0°C, p=0.016) temperatures. Sixteen (36%) patients became pyrexial, in seven (44%) of whom we found no cause other than the stroke. CONCLUSIONS: Normothermia is usual within the first 4 hours of stroke. Peak temperature occurs at 1.5 to 2 days after stroke, and is related to stroke severity/subtype and more closely associated with poor outcome than admission temperature. Temperature-outcome associations after stroke are complex, but normothermia on admission should not preclude randomisation of patients into trials of therapeutic hypothermia