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This chapter reviews the most researched psychotherapeutic interventions for individuals with cognitive impairment (CI) and common symptoms targeted by these interventions. Elements of assessment and psychotherapy modifications to consider when working with individuals with dementia are also discussed. Assessment components might include clarification of medical symptom overlap, collateral information, assessment instruments developed for individuals with cognitive difficulties, and incorporating consultation with other specialties. In general, clinicians should consider using simplified skills, increasing the number and frequency of sessions, shortening sessions, reducing group size, and providing more guidance during skill instruction and practice when working with individuals with cognitive impairments. Despite their promise and recommendations for their use, nonpharmacological therapies for individuals with dementia have a small research base and warrant continued development and evaluation.
This paper presents updated analyses on the genetic associations of sleep disruption in individuals with Alzheimer’s disease (AD). We published previously a study of the association between single nucleotide polymorphisms (SNPs) found in eight genes related to circadian rhythms and objective measures of sleep-wake disturbances in 124 individuals with AD. Here, we present new relevant analyses using polygenic risk scores (PRS) and variable number tandem repeats (VNTRs) enumerations. PRS were calculated using the genetic data from the original participants and relevant genome wide association studies (GWAS). VNTRs for the same circadian rhythm genes studied with SNPs were obtained from a separate cohort of participants using whole genome sequencing (WGS). Objectively (wrist actigraphy) determined wake after sleep onset (WASO) was used as a measure of sleep disruption. None of the PRS were associated with sleep disturbance. Computer analyses using VNTRseek software generated a total of 30 VNTRs for the circadian-related genes but none appear relevant to our objective sleep measure. In addition, of 71 neurotransmitter function-related genes, 29 genes had VNTRs that differed from the reference VNTR, but it was not clear if any of these might affect circadian function in AD patients. Although we have not found in either the current analyses or in our previous published analyses of SNPs any direct linkages between identified genetic factors and WASO, research in this area remains in its infancy.
In a saturated solution with dispersed clusters of a second phase, the mechanism by which the larger clusters grow at the expense of the smaller ones is called Ostwald ripening. Although the mechanism is well understood in situations where multiple clusters of gas exist in a liquid solution, evolution is much more complicated to predict when the two phases interact with a solid matrix, since the solid plays a significant role in determining the shape of the interface. In this paper, we study capillary dominated regimes in porous media where the driving force is inter-cluster diffusion. By decomposing the Ostwald ripening mechanism into two processes that operate on different time scales – the diffusion of solute gas in the liquid and the readjustment of the shape of the gas–liquid interface to accommodate a change in mass – we develop a sequential algorithm to solve for the evolution of systems with multiple gas ganglia. In the absence of a solid matrix, thermodynamic equilibrium is reached when all of the gas phase aggregates to form one large bubble. In porous media on the other hand, we find that ripening can lead to equilibrium situations with multiple disconnected ganglia, and that evolution is highly dependent on initial conditions and the structure of the solid matrix. The fundamental difference between the two cases is in the relationship between mass and capillary pressure.
Background: The timing of the circulatory determination of death for organ donation presents a medical and ethical challenge. Concerns have been raised about the timing of electrocerebral inactivity in relation to the cessation of circulatory function in organ donation after cardio-circulatory death. Nonprocessed electroencephalographic (EEG) measures have not been characterized and may provide insight into neurological function during this process. Methods: We assessed electrocortical data in relation to cardiac function after withdrawal of life-sustaining therapy and in the postmortem period after cardiac arrest for four patients in a Canadian intensive care unit. Subhairline EEG and cardio-circulatory monitoring including electrocardiogram, arterial blood pressure (ABP), and oxygen saturation were captured. Results: Electrocerebral inactivity preceded the cessation of the cardiac rhythm and ABP in three patients. In one patient, single delta wave bursts persisted following the cessation of both the cardiac rhythm and ABP. There was a significant difference in EEG amplitude between the 30-minute period before and the 5-minute period following ABP cessation for the group, but we did not observe any well-defined EEG states following the early cardiac arrest period. Conclusions: In a case series of four patients, EEG inactivity preceded electrocardiogram and ABP inactivity during the dying process in three patients. Further study of the electroencephalogram during the withdrawal of life sustaining therapies will add clarity to medical, ethical, and legal concerns for donation after circulatory determined death.
We report results of an experimental investigation into the effects of small-scale (mm–cm) heterogeneities on solute spreading and mixing in a Berea sandstone core. Pulse-tracer tests have been carried out in the Péclet number regime
and are supplemented by a unique combination of two imaging techniques. X-ray computed tomography (CT) is used to quantify subcore-scale heterogeneities in terms of permeability contrasts at a spatial resolution of approximately
, while [11C] positron emission tomography (PET) is applied to image the spatial and temporal evolution of the full tracer plume non-invasively. To account for both advective spreading and local (Fickian) mixing as driving mechanisms for solute transport, a streamtube model is applied that is based on the one-dimensional advection–dispersion equation. We refer to our modelling approach as semideterministic, because the spatial arrangement of the streamtubes and the corresponding solute travel times are known from the measured rock’s permeability map, which required only small adjustments to match the measured tracer breakthrough curve. The model reproduces the three-dimensional PET measurements accurately by capturing the larger-scale tracer plume deformation as well as subcore-scale mixing, while confirming negligible transverse dispersion over the scale of the experiment. We suggest that the obtained longitudinal dispersivity (
cm) is rock rather than sample specific, because of the ability of the model to decouple subcore-scale permeability heterogeneity effects from those of local dispersion. As such, the approach presented here proves to be very valuable, if not necessary, in the context of reservoir core analyses, because rock samples can rarely be regarded as ‘uniformly heterogeneous’.
Gaia's Radial Velocity Spectrometer (RVS) has been operating in routine phase for over one year since initial commissioning. RVS continues to work well but the higher than expected levels of straylight reduce the limiting magnitude. The end-of-mission radial-velocity (RV) performance requirement for G2V stars was 15 km s−1 at V = 16.5 mag. Instead, 15 km s−1 precision is achieved at 15 < V < 16 mag, consistent with simulations that predict a loss of 1.4 mag. Simulations also suggest that changes to Gaia's onboard software could recover ~0.14 mag of this loss. Consequently Gaia's onboard software was upgraded in April 2015. The status of this new commissioning period is presented, as well as the latest scientific performance of the on-ground processing of RVS spectra. We illustrate the implications of the RVS limiting magnitude on Gaia's view of the Milky Way's halo in 6D using the Gaia Universe Model Snapshot (GUMS).
To determine the incidence of high jugular bulb in a group of patients with definite Ménière's disease, and to investigate whether the position or size of the jugular bulb is significantly different in the affected ear than in the unaffected ear.
Retrospective review of patient charts, audiograms, and computed tomography scans to determine the position and size of the jugular bulb in the affected and contralateral ears, as well as other abnormalities.
High jugular bulb was found in 57.1 per cent of affected ears. Encroachment of the cochlear and vestibular aqueducts was apparent in 39.3 per cent and 35.7 per cent, respectively, of affected ears. Diverticulum and dehiscence were observed in 28.6 per cent of affected ears. High jugular bulb was significantly associated with encroachment of the cochlear aqueduct (p = 0.003).
The mediolateral and anteroposterior position of the jugular bulb determines encroachment of the surrounding structures. An abnormal position is postulated to contribute to the development of Ménière's disease.
Behavioral inhibition, a temperament identifiable in infancy, is associated with heightened withdrawal from social encounters. Prior studies raise particular interest in the striatum, which responds uniquely to monetary gains in behaviorally inhibited children followed into adolescence. Although behavioral manifestations of inhibition are expressed primarily in the social domain, it remains unclear whether observed striatal alterations to monetary incentives also extend to social contexts. In the current study, imaging data were acquired from 39 participants (17 males, 22 females; ages 16–18 years) characterized since infancy on measures of behavioral inhibition. A social evaluation task was used to assess neural response to anticipation and receipt of positive and negative feedback from novel peers, classified by participants as being of high or low interest. As with monetary rewards, striatal response patterns differed during both anticipation and receipt of social reward between behaviorally inhibited and noninhibited adolescents. The current results, when combined with prior findings, suggest that early-life temperament predicts altered striatal response in both social and nonsocial contexts and provide support for continuity between temperament measured in early childhood and neural response to social signals measured in late adolescence and early adulthood.
Advanced biomaterials that mimic the structure and function of native tissues and permit stem cells to adhere and differentiate is of paramount importance in the development of stem cell therapies for bone defects. Successful bone repair approaches may include an osteoconductive scaffold that permits excellent cell adhesion and proliferation, and cells with an osteogenic potential. The objective of this study was to evaluate the cell proliferation, viability and osteocyte differentiation of equine-derived bone marrow mesenchymal stem cells (EqMSCs) when seeded onto biocompatible and biodegradable calcium-deficient hydroxyapatite (CdHA) tubular-shaped bacterial cellulose scaffolds (BC-TS) of various sizes. The biocompatible gel-like BC-TS was synthesized using the bacterium Gluconacetobacter sucrofermentans under static culture in oxygen-permeable silicone tubes. The BC-TS scaffolds were modified using a periodate oxidation to yield biodegradable scaffolds. Additionally, CdHA was deposited in the scaffolds to mimic native bone tissues. The morphological properties of the resulting BC-TS and its composites were characterized using scanning electron microscopy. The ability of the BC-TS and its composites to support and maintain EqMSCs growth, proliferation and osteogenic differentiation in vitro was also assessed. BC-TS and its composites exhibited aligned nanofibril structures. MTS assay demonstrated increasing proliferation and viability with time (days 1, 2 and 3). Cell-scaffold constructs were cultured for 8 days under osteogenic conditions and the resulting osteocytes were positive for alizarin red. In summary, biocompatible and biodegradable CdHA BC-TS composites support the proliferation, viability and osteogenic differentiation of EqMSCs cultured onto its surface in vitro, allowing for future potential use for tissue engineering therapies.
The IceCube Neutrino Observatory was constructed at the South Pole during the 2004/05 to 2010/11 austral summer seasons. IceCube transforms 1 km3 of Antarctic ice into an astrophysical particle detector composed of 86 cables (strings) of optical sensors buried deep beneath the surface. Each string required drilling a borehole ∼60 cm in diameter to a depth of 2500 m. The 5 MW Enhanced Hot Water Drill was designed and built specifically for this task, capable of producing the required boreholes at a rate of one hole per 48 hours. Hot-water drilling on this scale presented unique challenges and was rich in lessons learned, yielding a collection of notable developments and takeaways (e.g. fuel-saving measures, thermal modeling, firn drilling and closed-loop computer control). Descriptions of system functionality and of lessons learned from IceCube drilling are presented.
We present the initial performance of the Gaia Radial Velocity Spectrometer, providing an overview of its performance, which is essentially nominal in terms of spectral resolution, throughput and operation, except for the presence of unexpectedly high levels of scattered background. This is mainly Solar in origin, and reduces the limiting magnitude for radial velocity measurements by ∼1 magnitude to V ∼ 16. Radial velocity calibration accuracies are compliant with requirements.
Thirty years ago, when theory emerged as integral to literary studies, investigations into the nature of reading dominated academic criticism. Since then, as cultural studies and historical approaches have gained ascendancy, critical focus on reading has waned. This collection of new essays by leading scholars of German and comparative literature, inspired by the work of the long-time and influential scholar of reading Clayton Koelb, puts the study of reading back at center stage, considering current theory on reading, emotion, and affect alongside historical investigations into cultural practices of reading as they have changed over time. Topics addressed include ancient practices of magic reading; Christian conversionary reading; the emergence of silent reading in the Middle Ages; Renaissance ekphrastic reading; homeopathy, reading and Romanticism; and German-Jewish reading cultures in the nineteenth century. The volume will be of interest to scholars and students of literary criticism, German Studies, comparative literature, and European history. Contributors: Richard V. Benson, Stanley Corngold, Eric Downing, Darryl Gless, Ruth V. Gross, Jonathan Hess, Janice Hewlett Koelb, Alice Kuzniar, Ann Marie Rasmussen, Jeffrey L. Sammons, Gary Shapiro, Kathryn Starkey, Christopher Wild. Eric Downing is Hanes Distinguished Term Professor of German, English, and Comparative Literature at the University of North Carolina-Chapel Hill. Jonathan M. Hess is Professor of German and Moses M. and Hannah L. Malkin Distinguished Term Professor of Jewish History and Culture at the University of North Carolina at Chapel Hill. Richard V. Benson is Visiting Assistant Professor of German at Valparaiso University.