Amyloid positron emission tomography candidates may focus more on benefits than risks of results disclosure

IntroductionGiven mounting calls to disclose biomarker test results to research participants, we explored factors underlying decisions by patients with mild cognitive impairment to receive amyloid imaging results.MethodsProspective, qualitative interviews were conducted with 59 participants (30 = mild cognitive impairment patients, 29 = care partners) from the scan arm of a randomized controlled trial on the effects of amyloid PET results disclosure in an Alzheimer Disease Research Center setting.ResultsSixty‐three percent of the participants were female, with an average age of 72.9 years, and most had greater than a high school level of education (80%). Primary motivations included: (1) better understanding one’s mild cognitive impairment etiology and prognosis to plan ahead, and (2) learning one’s brain amyloid status for knowledge’s sake, regardless of whether the information is actionable. Most participants demonstrated an adequate understanding of the scan’s limitations, yet instances of characterizing amyloid PET as a definitive test for Alzheimer’s disease occurred. Mention of potential drawbacks, such as negative psychological outcomes, was minimal, even among care partners.DiscussionFindings demonstrate a risk of disproportionate focus on possible benefits of testing among amyloid scan candidates and suggest a need to clearly emphasize the limitations of amyloid PET when counseling cognitively impaired patients and their families before testing. Future research should examine whether minimizing drawbacks at the pre‐imaging stage has adverse consequences on results disclosure.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152635/1/dad2jdadm201805003.pd

Lower thermospheric nitric oxide concentrations derived from WINDII observations of the green nightglow continuum at 553.1 nm

International audienceVertical profiles of nitric oxide in the altitude range 90 to 105 km are derived from 553 nm nightglow continuum measurements made with the Wind Imaging Interferometer (WINDII) on the Upper Atmosphere Research Satellite (UARS). The profiles are derived under the assumption that the continuum emission is due entirely to the NO+O air afterglow reaction. Vertical profiles of the atomic oxygen density, which are required to determine the nitric oxide concentrations, are derived from coordinated WINDII measurements of the atomic oxygen OI 557.7 nm nightglow emission. Data coverage for local solar times ranging from 20 h to 04 h, and latitudes ranging from 42°S to 42°N, is achieved by zonally averaging and binning data obtained on 18 nights during a two-month period extending from mid-November 1992 until mid-January 1993. The derived nitric oxide concentrations are significantly smaller than those obtained from rocket measurements of the airglow continuum but they do compare well with model expectations and nitric oxide densities measured using the resonance fluorescence technique on the Solar Mesosphere Explorer satellite. The near-global coverage of the WINDII observations and the similarities to the nitric oxide global morphology established from other satellite measurements strongly suggests that the NO+O reaction is the major source of the continuum near 553 nm and that there is no compelling reason to invoke additional sources of continuum emission in this immediate spectral region

Phenoconversion from probable rapid eye movement sleep behavior disorder to mild cognitive impairment to dementia in a population-based sample

© 2017 The Authors Introduction Rapid eye movement sleep behavior disorder (RBD) is strongly associated with synucleinopathies. In 2012, we reported an increased risk of mild cognitive impairment (MCI) and Parkinson disease (PD) in cognitively normal Olmsted County, Minnesota, residents, aged 70 to 89 years with probable RBD. Here, we examine their progression to dementia and other neurodegenerative phenotypes. Methods Fifteen participants with RBD who were diagnosed with either MCI or PD were longitudinally followed, and their subsequent clinical courses were reviewed. Results Over 6.4 ± 2.9 years, six of the 14 participants with MCI developed additional neurodegenerative signs, five of whom had Lewy body disease features. Four of them progressed to dementia at a mean age 84.8 ± 4.9 years, three of whom met the criteria for probable dementia with Lewy bodies. One subject with PD developed MCI, but not dementia. Discussion Our findings from the population-based sample of Olmsted County, Minnesota, residents suggest that a substantial number of RBD patients tend to develop overt synucleinopathy features over time, and RBD patients who develop MCI and subsequent dementia have clinical features most consistent with dementia with Lewy bodies

How Prosecutors and Defense Attorneys Differ in Their Use of Neuroscience Evidence

Much of the public debate surrounding the intersection of neuroscience and criminal law is based on assumptions about how prosecutors and defense attorneys differ in their use of neuroscience evidence. For example, according to some commentators, the defense’s use of neuroscience evidence will abdicate criminals of all responsibility for their offenses. In contrast, the prosecution’s use of that same evidence will unfairly punish the most vulnerable defendants as unfixable future dangers to society. This “double- edged sword” view of neuroscience evidence is important for flagging concerns about the law’s construction of criminal responsibility and punishment: it demonstrates that the same information about the defendant can either be mitigating or aggravating depending on who is raising it. Yet empirical assessments of legal decisions reveal a far more nuanced reality, showing that public beliefs about the impact of neuroscience on the criminal law can often be wrong. This Article takes an evidence-based and multidisciplinary approach to examining how courts respond to neuroscience evidence in capital cases when the defense presents it to argue that the defendant’s mental state at the time of the crime was below the given legal requisite due to some neurologic or cognitive deficiency

The association between pulse pressure change and cognition in late life: Age and where you start matters

AbstractIntroductionVariations across studies in the association between blood pressure (BP) and cognition might be explained partly by duration of exposure to hypertension and partly by nonrandom attrition over time. Pulse pressure (PP) reflects arterial stiffness which may better reflect chronicity of hypertension.MethodsOver six annual cycles, 1954 individuals aged 65+ years from a prospective population-based cohort underwent BP measurements and cognitive evaluations. We examined the relationship of change in five cognitive domains to longitudinal PP patterns across the late-life age spectrum, before and after stratifying by baseline systolic blood pressure (SBP) and adjusting for attrition.ResultsThere were four longitudinal PP patterns: stable normal, stable high, increasing, and decreasing. Those with lower baseline SBP and an increasing or stable high PP had less decline in cognition, an effect that was attenuated with aging. Among those with higher baseline SBP, there were no differences across PP groups, but increasing age was consistently associated with greater cognitive decline.DiscussionThe effect of PP on cognitive decline depends on age, baseline SBP, and the trajectory of PP change. Cardiovascular mechanisms underlying cognitive aging should be recognized as nuanced and dynamic processes when exploring prevention and treatment targets in the elderly, so that the optimal timing and type of intervention can be identified

First International Workshop on Grid Simulator Testing of Wind Turbine Drivetrains: Workshop Proceedings

This report summarizes the proceedings of the First International Workshop on Grid Simulator Testing of Wind Turbine Drivetrains, held from June 13 to 14, 2013, at the National Renewable Energy Laboratory's National Wind Technology Center, located south of Boulder, Colorado. The workshop was sponsored by the U.S. Department of Energy and cohosted by the National Renewable Energy Laboratory and Clemson University under ongoing collaboration via a cooperative research and development agreement. The purpose of the workshop was to provide a forum to discuss the research, testing needs, and state-of-the-art apparatuses involved in grid compliance testing of utility-scale wind turbine generators. This includes both dynamometer testing of wind turbine drivetrains ('ground testing') and field testing grid-connected wind turbines. Four sessions followed by discussions in which all attendees of the workshop were encouraged to participate comprised the workshop

Centerscope

Centerscope, formerly Scope, was published by the Boston University Medical Center "to communicate the concern of the Medical Center for the development and maintenance of improved health care in contemporary society.

A randomized controlled trial of amyloid positron emission tomography results disclosure in mild cognitive impairment

IntroductionRecent studies suggest that Alzheimer’s disease (AD) biomarker disclosure has no discernable psychological impact on cognitively healthy persons. Far less is known about how such results affect symptomatic individuals and their caregivers.MethodsRandomized controlled trial of 82 mild cognitive impairment (MCI) patient and caregiver dyads (total n = 164) to determine the effect of receiving amyloid positron emission tomography results on understanding of, and perceived efficacy to cope with, MCI over 52 weeks of follow‐up.ResultsGains in the primary outcomes were not consistently observed. Amyloid negative patients reported greater perceived ambiguity regarding MCI at follow‐up, while moderate and sustained emotional distress was observed in patients, and to a lesser extent, caregivers, of those who were amyloid positive. There was no corresponding increase in depressive symptoms.DiscussionThese findings point to the possibility that both MCI patients and caregivers may need emotional support after the disclosure of amyloid scan results.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163444/2/alz12129_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163444/1/alz12129.pd