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Objective: Detection of cognitive impairment suggestive of risk for Alzheimer’s disease (AD) progression is crucial to the prevention of incipient dementia. This study was performed to determine if performance on a novel object discrimination task improved identification of earlier deficits in older adults at risk for AD. Method: In total, 135 participants from the 1Florida Alzheimer’s Disease Research Center [cognitively normal (CN), Pre-mild cognitive impairment (PreMCI), amnestic mild cognitive impairment (aMCI), and dementia] completed a test of object discrimination and traditional memory measures in the context of a larger neuropsychological and clinical evaluation. Results: The Object Recognition and Discrimination Task (ORDT) revealed significant differences between the PreMCI, aMCI, and dementia groups versus CN individuals. Moreover, relative risk of being classified as PreMCI rather than CN increased as an inverse function of ORDT score. Discussion: Overall, the obtained results suggest that a novel object discrimination task improves the detection of very early AD-related cognitive impairment, increasing the window for therapeutic intervention. (JINS, 2019, 25, 688–698)
Wearable devices are fast evolving to address mobility and autonomy needs of elderly people who would benefit from physical assistance. Recent developments in soft robotics provide important opportunities to develop soft exoskeletons (also called exosuits) to enable both physical assistance and improved usability and acceptance for users. The XoSoft EU project has developed a modular soft lower limb exoskeleton to assist people with low mobility impairments. In this paper, we present the design of a soft modular lower limb exoskeleton to improve person’s mobility, contributing to independence and enhancing quality of life. The novelty of this work is the integration of quasi-passive elements in a soft exoskeleton. The exoskeleton provides mechanical assistance for subjects with low mobility impairments reducing energy requirements between 10% and 20%. Investigation of different control strategies based on gait segmentation and actuation elements is presented. A first hip–knee unilateral prototype is described, developed, and its performance assessed on a post-stroke patient for straight walking. The study presents an analysis of the human–exoskeleton energy patterns by way of the task-based biological power generation. The resultant assistance, in terms of power, was 10.9% ± 2.2% for hip actuation and 9.3% ± 3.5% for knee actuation. The control strategy improved the gait and postural patterns by increasing joint angles and foot clearance at specific phases of the walking cycle.
A core question in the debate about how to organise mental healthcare is whether in- and out-patient treatment should be provided by the same (personal continuity) or different psychiatrists (specialisation). The controversial debate drives costly organisational changes in several European countries, which have gone in opposing directions. The existing evidence is based on small and low-quality studies which tend to favour whatever the new experimental organisation is.
We compared 1-year clinical outcomes of personal continuity and specialisation in routine care in a large scale study across five European countries.
This is a 1-year prospective natural experiment conducted in Belgium, England, Germany, Italy and Poland. In all these countries, both personal continuity and specialisation exist in routine care. Eligible patients were admitted for psychiatric in-patient treatment (18 years of age), and clinically diagnosed with a psychotic, mood or anxiety/somatisation disorder.
Outcomes were assessed 1 year after the index admission. The primary outcome was re-hospitalisation and analysed for the full sample and subgroups defined by country, and different socio-demographic and clinical criteria. Secondary outcomes were total number of inpatient days, involuntary re-admissions, adverse events and patients’ social situation. Outcomes were compared through mixed regression models in intention-to-treat analyses. The study is registered (ISRCTN40256812).
We consecutively recruited 7302 patients; 6369 (87.2%) were followed-up. No statistically significant differences were found in re-hospitalisation, neither overall (adjusted percentages: 38.9% in personal continuity, 37.1% in specialisation; odds ratio = 1.08; confidence interval 0.94–1.25; p = 0.28) nor for any of the considered subgroups. There were no significant differences in any of the secondary outcomes.
Whether the same or different psychiatrists provide in- and out-patient treatment appears to have no substantial impact on patient outcomes over a 1-year period. Initiatives to improve long-term outcomes of psychiatric patients may focus on aspects other than the organisation of personal continuity v. specialisation.
Two new species of egg parasitoids, Oobius saimaensis Yao and Mottern new species and Oobius fleischeri Yao and Duan new species (Hymenoptera: Encyrtidae), are described from eggs of Agrilus fleischeri Obenberger, 1925 (Coleoptera: Buprestidae). Agrilus fleischeri is a phloem-feeding woodborer of poplar (Populus Linnaeus; Salicaceae) in northeastern China. These two species can be distinguished morphologically as O. fleischeri has five tarsomeres and O. saimaensis has four tarsomeres. Although O. saimaensis is morphologically similar to its sympatric congener O. agrili Zhang and Hang, 2005, an important natural enemy of the invasive emerald ash borer, Agrilus planipennis Fairmaire, 1888, molecular phylogenetics and morphological data indicate that they are distinct species. Phylogenetic relationships among the new species and other closely related species are also inferred by using DNA sequence data from several ribosomal and mitochondrial genes. In addition, we expand the known distribution of Oobius primorskyensis Yao and Duan, 2016 to include South Korea.
Tett, Hundley, and Christiansen (2017) raise an important issue related to meta-analysis and our frequent overinterpretation of point estimates to the diminishment of variability of the estimate. We view this as analogous to the situation in which weather forecasters communicate the likely track of hurricanes. Such predictions involve point estimates of where the center of the storm is likely to be at some future time. These point estimates can be connected to identify the most likely path of the storm. In addition to these point estimates, however, forecasters caution that we should also attend to the “cone of uncertainty.” That is, we should not focus exclusively on the point estimate to the exclusion of the errors of prediction.
Exercise during pregnancy has beneficial effects on maternal and offspring’s health in humans and mice. The underlying mechanisms remain unclear. This comparative study aimed to determine the long-term effects of an exercise program on metabolism, weight gain, body composition and changes in hormones [insulin, leptin, brain-derived neurotrophic factor (BDNF)]. Pregnant women (n=34) and mouse dams (n=44) were subjected to an exercise program compared with matched controls (period I). Follow-up in the offspring was performed over 6 months in humans, corresponding to postnatal day (P) 21 in mice (period II). Half of the mouse offspring was challenged with a high-fat diet (HFD) for 6 weeks between P70 and P112 (period III). In period I, exercise during pregnancy led to 6% lower fat content, 40% lower leptin levels and an increase of 50% BDNF levels in humans compared with controls, which was not observed in mice. After period II in humans and mice, offspring body weight did not differ from that of the controls. Further differences were observed in period III. Offspring of exercising mouse dams had significantly lower fat mass and leptin levels compared with controls. In addition, at P112, BDNF levels in offspring were significantly higher from exercising mothers while this effect was completely blunted by HFD feeding. In this study, we found comparable effects on maternal and offspring’s weight gain in humans and mice but different effects in insulin, leptin and BDNF. The long-term potential protective effects of exercise on biomarkers should be examined in human studies.
Africa has a shortage of animal products but increasing demand because of population growth, urbanisation and changing consumer patterns. Attempts to boost livestock production through the use of breeding technologies such as artificial insemination (AI) have been failing in many countries because costs have escalated and success rates have been relatively low. One example is Kenya, a country with a relatively large number of cows and a dairy industry model relevant to neighbouring countries. There, an innovative dairy marketing approach (farmer-owned collective marketing systems called dairy hubs) has been implemented to enhance access to dairy markets and dairy-related services, including breeding services such as AI. So far, the rate of participation in these dairy hubs has been slow and mixed. In order to understand this phenomenon better and to inform dairy-related development activities by the Kenyan government, we investigated which characteristics of AI services, offered through the dairy hubs, farmers prefer. To do so, we applied a choice experiment (CE), a non-market valuation technique, which allowed us to identify farmers’ preferences for desired characteristics should more dairy hubs be installed in the future. This is the first study to use a CE to evaluate breeding services in Kenya and the results can complement findings of studies of breeding objectives and selection criteria. The results of the CE reveal that dairy farmers prefer to have AI services offered rather than having no service. Farmers prefer AI services to be available at dairy hubs rather than provided by private agents not affiliated to the hubs, to have follow-up services for pregnancy detections, and to use sexed semen rather than conventional semen. Farmers would further like some flexibility in payment systems which include input credit, and are willing to share the costs of any AI repeats that may need to occur. These results provide evidence of a positive attitude to AI services provided through the hubs, which could mean that AI uptake would improve if service characteristics are improved to match farmer preferences. The dairy hubs concept is currently in the implementation phase with most hubs at startup phase, hence understanding which AI service characteristics farmers prefer can inform the design of high-quality and cost-effective AI services in the future.
The Dark Energy Survey is undertaking an observational programme imaging 1/4 of the southern hemisphere sky with unprecedented photometric accuracy. In the process of observing millions of faint stars and galaxies to constrain the parameters of the dark energy equation of state, the Dark Energy Survey will obtain pre-discovery images of the regions surrounding an estimated 100 gamma-ray bursts over 5 yr. Once gamma-ray bursts are detected by, e.g., the Swift satellite, the DES data will be extremely useful for follow-up observations by the transient astronomy community. We describe a recently-commissioned suite of software that listens continuously for automated notices of gamma-ray burst activity, collates information from archival DES data, and disseminates relevant data products back to the community in near-real-time. Of particular importance are the opportunities that non-public DES data provide for relative photometry of the optical counterparts of gamma-ray bursts, as well as for identifying key characteristics (e.g., photometric redshifts) of potential gamma-ray burst host galaxies. We provide the functional details of the DESAlert software, and its data products, and we show sample results from the application of DESAlert to numerous previously detected gamma-ray bursts, including the possible identification of several heretofore unknown gamma-ray burst hosts.
To investigate natural enemies of emerald ash borer (EAB), Agrilus planipennis Fairmaire (Coleoptera: Buprestidae), in northeastern China, we conducted field surveys of ash (Fraxinus Linnaeus (Oleaceae)) trees in semi-natural forests and plantations at variable EAB densities from 2008 to 2013. Our surveys revealed a complex of natural enemies including eight hymenopteran parasitoids and two apparently parasitic Coleoptera, woodpeckers, and several undetermined mortality factors. Parasitoid complex abundance and its contribution to EAB mortality varied with the time of year, type of ash stands, and geographic regions. The egg parasitoid Oobius agrili Zhang and Huang (Hymenoptera: Encyrtidae) and the larval parasitoid Tetrastichus planipennisi Yang (Hymenoptera: Eulophidae) were frequently observed in Jilin, Liaoning, and Heilongjiang provinces and in Beijing, but not in Tianjin. Spathius agrili Yang (Hymenoptera: Braconidae), however, was more prevalent near Beijing and further south in Tianjin. Larvae of two species of apparently parasitic beetle, Tenerus Laporte (Coleoptera: Cleridae) species and Xenoglena quadrisignata Mannerheim (Coleoptera: Trogossitidae), were also recovered attacking overwintering EAB in Liaoning Province, with Tenerus species being a dominant mortality agent (~13%). Our findings support the need to consider the geographic origin of insect natural enemies for EAB biocontrol, as well as an expanded foreign exploration for EAB natural enemies throughout its native range in Asia.
Our aim was to evaluate the frequency and treatment of psychiatric symptoms in patients at palliative care units (PCUs).
Patients admitted to one of five participating PCUs in Austria were included. The short version of the Patient Health Questionnaire (PHQ–D) was used to evaluate their mental health status. Pain intensity was rated on a numeric rating scale (NRS) from 0 to 10 by patients and physicians. Patients with a previously diagnosed psychiatric disorder were compared to those without or with newly diagnosed psychiatric symptoms, based on PHQ–D results. Pain and psychopharmacological medication were assessed. Opioid doses were converted into oral morphine equivalents (OMEs).
Some 68 patients were included. Previously undetected psychiatric symptoms were identified in 38% (26 of 68), preexisting psychiatric comorbidities were evident in 25% (17), and no psychiatric symptoms were observed in 37% (25). Patients with a preexisting psychiatric comorbidity received antidepressants and benzodiazepines significantly more often than patients without or with previously undetected psychiatric symptoms (p < 0.001). Patient and physician median NRS ratings of pain intensity correlated significantly (p = 0.001). Median NRS rating showed no significant difference between patients with preexisting, previously undetected, or without psychiatric symptoms. OMEs did not differ significantly between preexisting, without, or previously undetected psychiatric symptoms. Patients with undetected and preexisting psychiatric comorbidities had a greater impairment in their activities of daily living than patients without psychiatric symptoms (p = 0.003).
Significance of Results:
Undetected psychiatric comorbidities are common in patients receiving palliative care. Screening for psychiatric symptoms should be integrated into standard palliative care to optimize treatment and reduce the psychosocial burden of the disease.
Theoretical modeling of the daytime Venus ionosphere can be used to augment the measurements of Mariner V made during the 1967 fly-by mission of Venus. The models discussed here are obtained by solving the equations of heat conduction for the electron, ion, and neutral gases along with the momentum and chemical equations for the charged particle densities [1, 2, 3]. When the model is brought into conformity with as much of the data as is possible, constraints can be placed on some of the unknown parameters such as the electron and ion temperatures, and the strength of the magnetic field in the topside Venus ionosphere.
We derive zphot for sources in the entire (~0.4 deg2) H-HDF-N field with the EAzY code, based on PSF-matched broad-band (U band to IRAC 4.5 μm) photometry. Our catalog consists of a total of 131,678 sources. We find σNMAD = 0.029 for non-X-ray sources. We also classify each object as a star or galaxy through SED fitting. Furthermore, we match our catalog with the 2 Ms CDF-N main X-ray catalog. For the 462 matched non-stellar X-ray sources, we improve their zphot quality (σNMAD = 0.035) by adding three additional AGN templates. We make our photometry and zphot catalog publicly available.
This was a prospective longitudinal multisite study of the effects of prenatal cocaine and/or opiate exposure on temperament in 4-month-olds of the Maternal Lifestyle Study (N = 958: 366 cocaine exposed, 37 opiate exposed, 33 exposed to both drugs, 522 matched comparison). The study evaluated positivity and negativity during The Behavior Assessment of Infant Temperament (Garcia Coll et al., 1988). Parents rated temperament (Infant Behavior Questionnaire; Rothbart, 1981). Cocaine-exposed infants showed less positivity overall, mainly during activity and threshold items, more negativity during sociability items, and less negativity during irritability and threshold items. Latent profile analysis indicated individual temperament patterns were best described by three groups: low/moderate overall reactivity, high social negative reactivity, and high nonsocial negative reactivity. Infants with heavy cocaine exposure were more likely in high social negative reactivity profile, were less negative during threshold items, and required longer soothing intervention. Cocaine- and opiate-exposed infants scored lower on Infant Behavior Questionnaire smiling and laughter and duration of orienting scales. Opiate-exposed infants were rated as less respondent to soothing. By including a multitask measure of temperament we were able to show context-specific behavioral dysregulation in prenatally cocaine-exposed infants. The findings indicate flatter temperament may be specific to nonsocial contexts, whereas social interactions may be more distressing for cocaine-exposed infants.
First detected in North America in 2002, the emerald ash borer (EAB) (Agrilus planipennis Fairmaire; Coleoptera: Buprestidae), an invasive phloem-feeding beetle from Asia, has killed tens of millions of ash (Fraxinus Linnaeus; Oleaceae) trees. Although few parasitoids attack EAB in North America, three parasitoid species were found attacking EAB in China: the egg parasitoid Oobius agrili Zhang and Huang (Hymenoptera: Encyrtidae) and two larval parasitoids Tetrastichus planipennisi Yang (Hymenoptera: Eulophidae) and Spathius agrili Yang (Hymenoptera: Braconidae). In 2007, classical biological control of EAB began in the United States of America after release of these three species was approved. In 2013, release of the larval parasitoids was approved in Canada. Research continues at study sites in Michigan, United States of America where the establishment, prevalence, and spread of O. agrili and T. planipennisi have been monitored since 2008. However, establishment of S. agrili remains unconfirmed in northern areas, and its release is now restricted to regions below the 40th parallel. In 2015, approval for release of Spathius galinae Belokobylskij (Hymenoptera: Braconidae), an EAB larval parasitoid from the Russian Far East, may be granted in the United States of America. Researchers are guardedly optimistic that a complex of introduced and native natural enemies will regulate EAB densities below a tolerance threshold for survival of ash species or genotypes in forested ecosystems.
Concerning a materials ability to convert heat to electrical energy, the electrical power factor S2/ρ as well as the thermal conductivity at elevated temperatures are of special interest. Since Flash experiments measure the thermal diffusivity and standard steady-state heat-flow experiments are inaccurate at elevated temperatures due to radiation errors inherent to this technique, direct and accurate thermal conductivity data on type-I clathrate single crystals at elevated temperatures are scarce in literature. Here we report 3ω thermal conductivity data on single crystalline Ba8Cu5.09Ge40.91 (BCG), La1.23Ba6.99Au5.91Si39.87, and Ce1.06Ba6.91Au5.56Si40.47 in the temperature range between 80 and 330 K, and specific heat data on BCG between 2 and 300 K. The comparison of our room temperature phonon thermal conductivity data (κph) to results on transition metal (TM) free type-I clathrates in terms of the guest free space (Rfree) suggests a stronger dependence of κph on Rfree for the clathrates containing TM elements.
Pet owners desire treats with adequate nutritional profiles, functional benefits, long-lasting properties and an interactive nature. Therefore, it is pivotal to understand the digestion characteristics of treats produced by different processing methods and having variable nutritional composition. The objective of the present study was to measure in vitro disappearance characteristics of selected categories of commercially available treats. In vitro procedures developed by Boisen and Eggum in 1991 were modified to handle larger sample sizes. Treat samples were evaluated in triplicate. Following incubation, in vitro DM disappearance (DMD) was calculated. In vitro DMD of selected treats varied widely. For the gastric phase, DMD ranged from 6·9 to 88·8 %, whereas intestinal phase digestion resulted in a DMD range of 10·7–100·0 % (P < 0·05). Because of differences in treat composition and size, they were divided into six categories: Biscuit, Bone, Chew, Dental, Meat Product and Rawhide. In general, Bone was the least digestible treat category in both gastric and intestinal phases. Meat Product and Rawhide treats had a DMD of 71·5–100 % after the intestinal phase, whereas Biscuit had values above 93 %. Chew and Dental treats had a wide DMD range (54·5–100 %). Understanding the DMD of commercially available treats is important to verify their safety for consumption and potential digestibility once ingested. These data indicate wide variation in DMD among and within different treat categories. This information will assist pet food sale associates, pet owners and veterinarians to make more educated decisions when it relates to selection and recommendations about commercially available treats. Future work is needed to expand the knowledge on in vitro DMD and safety of treats and to further investigate their impact on in vivo DM digestibility once fed to dogs.