Kinematic analysis of handwriting movements in patients with Alzheimer's disease, mild cognitive impairment, depression and healthy subjects

A variety of studies have demonstrated that motor disorders, parkinsonism and extrapyramidal motor symptoms (EPMS) are common in patients with Alzheimer's disease (AD). Several studies have reported an association of EPMS with severity, progression and poor prognosis of AD. The majority of these studies used clinical assessments for the rating of EPMS. In this study, kinematic handwriting analysis was used to quantify differences in fine hand motor function in patients with probable AD and mild cognitive impairment (MCl, as an assumed initial stage of AD) compared to depressed patients and healthy controls. Both patients with MCl and patients with probable AD exhibited loss of fine motor performance. Movements of AD patients were significantly less regular than those of healthy controls. Copyright (C) 2003 S. Karger AG, Basel

Time of emergence of climate signals

The time at which the signal of climate change emerges from the noise of natural climate variability (Time of Emergence, ToE) is a key variable for climate predictions and risk assessments. Here we present a methodology for estimating ToE for individual climate models, and use it to make maps of ToE for surface air temperature (SAT) based on the CMIP3 global climate models. Consistent with previous studies we show that the median ToE occurs several decades sooner in low latitudes, particularly in boreal summer, than in mid-latitudes. We also show that the median ToE in the Arctic occurs sooner in boreal winter than in boreal summer. A key new aspect of our study is that we quantify the uncertainty in ToE that arises not only from inter-model differences in the magnitude of the climate change signal, but also from large differences in the simulation of natural climate variability. The uncertainty in ToE is at least 30 years in the regions examined, and as much as 60 years in some regions. Alternative emissions scenarios lead to changes in both the median ToE (by a decade or more) and its uncertainty. The SRES B1 scenario is associated with a very large uncertainty in ToE in some regions. Our findings have important implications for climate modelling and climate policy which we discuss

Human influence strengthens the contrast between tropical wet and dry regions

Climate models predict a strengthening contrast between wet and dry regions in the tropics and subtropics (30 °S–30 °N), and data from the latest model intercomparison project (CMIP6) support this expectation. Rainfall in ascending regions increases, and in descending regions decreases in climate models, reanalyses, and observational data. This strengthening contrast can be captured by tracking the rainfall change each month in the wettest and driest third of the tropics and subtropics combined. Since wet and dry regions are selected individually every month for each model ensemble member, and the observations, this analysis is largely unaffected by biases in location of precipitation features. Blended satellite and in situ data from 1988–2019 support the CMIP6-model-simulated tendency of sharpening contrasts between wet and dry regions, with rainfall in wet regions increasing substantially opposed by a slight decrease in dry regions. We detect the effect of external forcings on tropical and subtropical observed precipitation in wet and dry regions combined, and attribute this change for the first time to anthropogenic and natural forcings separately. Our results show that most of the observed change has been caused by increasing greenhouse gases. Natural forcings also contribute, following the drop in wet-region precipitation after the 1991 eruption of Mount Pinatubo, while anthropogenic aerosol effects show only weak trends in tropic-wide wet and dry regions consistent with flat global aerosol forcing over the analysis period. The observed response to external forcing is significantly larger ( p > 0.95) than the multi-model mean simulated response. As expected from climate models, the observed signal strengthens further when focusing on the wet tail of spatial distributions in both models and data

Suizid und Internet

The number of people aged 14 and older that use the Internet in Germany has doubled to 35.7 millions (55.3%) since the year 2000. The Internet also more and more expands into the domain of psychiatry and psychotherapy, and is used by psychiatric patients for information, communication and therapeutic purposes. Nevertheless, the infinite possibilities of the World Wide Web are linked with several advantages and disadvantages. Easily accessible information, numerous opportunities for exchange among like-minded people and therapeutic support from online therapies are juxtaposed with such risks as frequently lacking quality and transparency of the available information, possible enhancement of social withdrawal and certain Websites concerning suicide. If the mentioned risks of the Internet rather provoke new problems and trigger suicidality or if the chance of an easily accessible online discussion rather results in mental relief cannot be answered generally

Developing social capital in implementing a complex intervention: a process evaluation of the early implementation of a suicide prevention intervention in four European countries

<p>Background: Variation in the implementation of complex multilevel interventions can impact on their delivery and outcomes. Few suicide prevention interventions, especially multilevel interventions, have included evaluation of both the process of implementation as well as outcomes. Such evaluation is essential for the replication of interventions, for interpreting and understanding outcomes, and for improving implementation science. This paper reports on a process evaluation of the early implementation stage of an optimised suicide prevention programme (OSPI-Europe) implemented in four European countries.</p> <p>Methods: The process analysis was conducted within the framework of a realist evaluation methodology, and involved case studies of the process of implementation in four European countries. Datasets include: repeated questionnaires to track progress of implementation including delivery of individual activities and their intensity; serial interviews and focus groups with stakeholder groups; and detailed observations at OSPI implementation team meetings.</p> <p>Results: Analysis of local contexts in each of the four countries revealed that the advisory group was a key mechanism that had a substantial impact on the ease of implementation of OSPI interventions, particularly on their ability to recruit to training interventions. However, simply recruiting representatives of key organisations into an advisory group is not sufficient to achieve impact on the delivery of interventions. In order to maximise the potential of high level ‘gatekeepers’, it is necessary to first transform them into OSPI stakeholders. Motivations for OSPI participation as a stakeholder included: personal affinity with the shared goals and target groups within OSPI; the complementary and participatory nature of OSPI that adds value to pre-existing suicide prevention initiatives; and reciprocal reward for participants through access to the extended network capacity that organisations could accrue for themselves and their organisations from participation in OSPI.</p> <p>Conclusions: Exploring the role of advisory groups and the meaning of participation for these participants revealed some key areas for best practice in implementation: careful planning of the composition of the advisory group to access target groups; the importance of establishing common goals; the importance of acknowledging and complementing existing experience and activity; and facilitating an equivalence of benefit from network participation.</p&gt

A climate change simulation starting from 1935

Due to restrictions in the available computing resources and a lack of suitable observational data, transient climate change experiments with global coupled ocean-atmosphere models have been started from an initial state at equilibrium with the present day forcing. The historical development of greenhouse gas forcing from the onset of industrialization until the present has therefore been neglected. Studies with simplified models have shown that this "cold start" error leads to a serious underestimation of the anthropogenic global warming. In the present study, a 150-year integration has been carried out with a global coupled ocean-atmosphere model starting from the greenhouse gas concentration observed in 1935, i.e., at an early time of industrialization. The model was forced with observed greenhouse gas concentrations up to 1985, and with the equivalent C02 concentrations stipulated in Scenario A ("Business as Usual") of the Intergovernmental Panel on Climate Change from 1985 to 2085. The early starting date alleviates some of the cold start problems. The global mean near surface temperature change in 2085 is about 0.3 K (ca. 10) higher in the early industrialization experiment than in an integration with the same model and identical Scenario A greenhouse gas forcing, but with a start date in 1985. Comparisons between the experiments with early and late start dates show considerable differences in the amplitude of the regional climate change patterns, particularly for sea level. The early industrialization experiment can be used to obtain a first estimate of the detection time for a greenhouse-gas-induced near-surface temperature signal. Detection time estimates are obtained using globally and zonally averaged data from the experiment and a long control run, as well as principal component time series describing the evolution of the dominant signal and noise modes. The latter approach yields the earliest detection time (in the decade 1990-2000) for the time-evolving near-surface temperature signal. For global-mean temperatures or for temperatures averaged between 45°N and 45°S, the signal detection times are in the decades 2015-2025 and 2005-2015, respectively. The reduction of the "cold start" error in the early industrialization experiment makes it possible to separate the near-surface temperature signal from the noise about one decade earlier than in the experiment starting in 1985. We stress that these detection times are only valid in the context of the coupled model's internally-generated natural variability, which possibly underestimates low frequency fluctuations and does not incorporate the variance associated with changes in external forcing factors, such as anthropogenic sulfate aerosols, solar variability or volcanic dust. © 1995 Springer-Verlag

The effect of uncertainties in natural forcing records on simulated temperature during the last millennium

Here we investigate how uncertainties in the solar and volcanic forcing records of the past millennium affect the large-scale temperature response using a two-box impulse response model. We use different published solar forcing records and present a new volcanic forcing ensemble that accounts for random uncertainties in eruption dating and sulfur injection amount. The simulations are compared to proxy reconstructions from PAGES 2k and Northern Hemispheric tree ring data. We find that low solar forcing is most consistent with all the proxy reconstructions, even when accounting for volcanic uncertainty. We also find that the residuals are in line with CMIP6 control variability at centennial timescales. Volcanic forcing uncertainty induces a significant spread in the temperature response, especially at periods of peak forcing. For individual eruptions and superposed epoch analyses, volcanic uncertainty can strongly affect the agreement with proxy reconstructions and partly explain known proxy–model discrepancies