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Attentional impairments are common in dementia with Lewy bodies and its prodromal stage of mild cognitive impairment (MCI) with Lewy bodies (MCI-LB). People with MCI may be capable of compensating for subtle attentional deficits in most circumstances, and so these may present as occasional lapses of attention. We aimed to assess the utility of a continuous performance task (CPT), which requires sustained attention for several minutes, for measuring attentional performance in MCI-LB in comparison to Alzheimer’s disease (MCI-AD), and any performance deficits which emerged with sustained effort.
We included longitudinal data on a CPT sustained attention task for 89 participants with MCI-LB or MCI-AD and 31 healthy controls, estimating ex-Gaussian response time parameters, omission and commission errors. Performance trajectories were estimated both cross-sectionally (intra-task progress from start to end) and longitudinally (change in performance over years).
While response times in successful trials were broadly similar, with slight slowing associated with clinical parkinsonism, those with MCI-LB made considerably more errors. Omission errors were more common throughout the task in MCI-LB than MCI-AD (OR 2.3, 95% CI: 1.1–4.7), while commission errors became more common after several minutes of sustained attention. Within MCI-LB, omission errors were more common in those with clinical parkinsonism (OR 1.9, 95% CI: 1.3–2.9) or cognitive fluctuations (OR 4.3, 95% CI: 2.2–8.8).
Sustained attention deficits in MCI-LB may emerge in the form of attentional lapses leading to omissions, and a breakdown in inhibitory control leading to commission errors.
The present study aimed to clarify the neuropsychological profile of the emergent diagnostic category of Mild Cognitive Impairment with Lewy bodies (MCI-LB) and determine whether domain-specific impairments such as in memory were related to deficits in domain-general cognitive processes (executive function or processing speed).
Patients (n = 83) and healthy age- and sex-matched controls (n = 34) underwent clinical and imaging assessments. Probable MCI-LB (n = 44) and MCI-Alzheimer’s disease (AD) (n = 39) were diagnosed following National Institute on Aging-Alzheimer’s Association (NIA-AA) and dementia with Lewy bodies (DLB) consortium criteria. Neuropsychological measures included cognitive and psychomotor speed, executive function, working memory, and verbal and visuospatial recall.
MCI-LB scored significantly lower than MCI-AD on processing speed [Trail Making Test B: p = .03, g = .45; Digit Symbol Substitution Test (DSST): p = .04, g = .47; DSST Error Check: p < .001, g = .68] and executive function [Trail Making Test Ratio (A/B): p = .04, g = .52] tasks. MCI-AD performed worse than MCI-LB on memory tasks, specifically visuospatial (Modified Taylor Complex Figure: p = .01, g = .46) and verbal (Rey Auditory Verbal Learning Test: p = .04, g = .42) delayed recall measures. Stepwise discriminant analysis correctly classified the subtype in 65.1% of MCI patients (72.7% specificity, 56.4% sensitivity). Processing speed accounted for more group-associated variance in visuospatial and verbal memory in both MCI subtypes than executive function, while no significant relationships between measures were observed in controls (all ps > .05)
MCI-LB was characterized by executive dysfunction and slowed processing speed but did not show the visuospatial dysfunction expected, while MCI-AD displayed an amnestic profile. However, there was considerable neuropsychological profile overlap and processing speed mediated performance in both MCI subtypes.
The coronavirus disease 2019 (COVID-19) pandemic has resulted in shortages of personal protective equipment (PPE), underscoring the urgent need for simple, efficient, and inexpensive methods to decontaminate masks and respirators exposed to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). We hypothesized that methylene blue (MB) photochemical treatment, which has various clinical applications, could decontaminate PPE contaminated with coronavirus.
The 2 arms of the study included (1) PPE inoculation with coronaviruses followed by MB with light (MBL) decontamination treatment and (2) PPE treatment with MBL for 5 cycles of decontamination to determine maintenance of PPE performance.
MBL treatment was used to inactivate coronaviruses on 3 N95 filtering facepiece respirator (FFR) and 2 medical mask models. We inoculated FFR and medical mask materials with 3 coronaviruses, including SARS-CoV-2, and we treated them with 10 µM MB and exposed them to 50,000 lux of white light or 12,500 lux of red light for 30 minutes. In parallel, integrity was assessed after 5 cycles of decontamination using multiple US and international test methods, and the process was compared with the FDA-authorized vaporized hydrogen peroxide plus ozone (VHP+O3) decontamination method.
Overall, MBL robustly and consistently inactivated all 3 coronaviruses with 99.8% to >99.9% virus inactivation across all FFRs and medical masks tested. FFR and medical mask integrity was maintained after 5 cycles of MBL treatment, whereas 1 FFR model failed after 5 cycles of VHP+O3.
MBL treatment decontaminated respirators and masks by inactivating 3 tested coronaviruses without compromising integrity through 5 cycles of decontamination. MBL decontamination is effective, is low cost, and does not require specialized equipment, making it applicable in low- to high-resource settings.
Background: In July 2017, the Ethiopian Public Health Institute (EPHI) launched an antimicrobial resistance (AMR) surveillance network at 4 sentinel laboratories. The National Clinical Bacteriology and Mycology Laboratory (NRL) at EPHI performs monthly confirmatory testing on a subset of isolates submitted by these sites. We assessed the existing confirmatory testing program to identify gaps and develop solutions, including a monitoring and evaluation (M&E) system. Methods: We assembled a technical working group (TWG) of key stakeholders. Laboratory site visits included workflow observation, process mapping, document review, and technologist interviews. Proposed solutions to observed gaps were drafted in formats consistent with their intended application. Feedback from the TWG was incorporated into final drafts. Available AMR network staff members were trained remotely, and they will train remaining staff. Results: Table 1 describes major gaps and solutions identified. Conclusions: Confirmatory testing provides a mechanism to evaluate laboratory testing proficiency, target improvements, and estimate surveillance data quality, yet standardized methods were lacking. Our efforts highlight key components of confirmatory testing programs and provide a model for use in laboratories with similar needs.
Late-life depression (LLD) is associated with poor social functioning. However, previous research uses bias-prone self-report scales to measure social functioning and a more objective measure is lacking. We tested a novel wearable device to measure speech that participants encounter as an indicator of social interaction.
Twenty nine participants with LLD and 29 age-matched controls wore a wrist-worn device continuously for seven days, which recorded their acoustic environment. Acoustic data were automatically analysed using deep learning models that had been developed and validated on an independent speech dataset. Total speech activity and the proportion of speech produced by the device wearer were both detected whilst maintaining participants' privacy. Participants underwent a neuropsychological test battery and clinical and self-report scales to measure severity of depression, general and social functioning.
Compared to controls, participants with LLD showed poorer self-reported social and general functioning. Total speech activity was much lower for participants with LLD than controls, with no overlap between groups. The proportion of speech produced by the participants was smaller for LLD than controls. In LLD, both speech measures correlated with attention and psychomotor speed performance but not with depression severity or self-reported social functioning.
Using this device, LLD was associated with lower levels of speech than controls and speech activity was related to psychomotor retardation. We have demonstrated that speech activity measured by wearable technology differentiated LLD from controls with high precision and, in this study, provided an objective measure of an aspect of real-world social functioning in LLD.
Dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) have substantial clinical and biological overlap, with cognitive deficits typically observed in the executive and visuospatial domains. However, the neuropsychological profiles of mild cognitive impairment (MCI) associated with these disorders are not well understood.
This systematic review examined existing literature on cognition in MCI due to LB disease (MCI-LB) and PD (PD-MCI) using an electronic search of seven databases (Medline, Embase, Psychinfo, PubMed, ProQuest, Scopus, and ScienceDirect). MCI-LB results were reviewed narratively given the small number of resulting papers (n = 7). Outcome variables from PD-MCI studies (n = 13) were extracted for meta-analysis of standardised mean differences (SMD).
In MCI-LB, executive dysfunction and slowed processing speed were the most prominent impairments, while visuospatial and working memory (WM) functions were also poor. MCI-LB scored significantly lower on verbal memory tests relative to controls, but significantly higher than patients with MCI due to Alzheimer’s disease. Quantitative analysis of studies in PD-MCI showed a similar profile of impairment, with the largest deficits in visuospatial function (Benton Judgement of Line Orientation, SMD g = −2.09), executive function (Trail Making Test B, SMD g = −1.65), verbal ability (Naming Tests, SMD g = −0.140), and WM (Trail Making Test A, SMD g = −1.20). In both MCI-LB and PD-MCI, verbal and visuospatial memory retrieval was impaired, while encoding and storage appeared relatively intact.
The findings of this systematic review indicate similar neuropsychological profiles in the MCI stages of DLB and PDD. Executive impairment may at least partially explain poor performance in other domains.
The fall of the Berlin Wall in 1989 and the unification of Germany in 1990 allowed East Germans to finally travel freely to western countries. This new freedom to travel to the West not only impacted the worldview of many former GDR citizens, but also found its way into the writings of East German authors throughout the 1990s and into the present. In her study on contemporary German literature around the turn of the twenty-first century, the literary critic Christine Cosentino examines several tendencies by which contemporary German authors deal with America in their texts. One tendency she describes is “die Reise in die USA als Topos für die Suche nach Identität, die den politischen Hintergrund weitgehend ausspart” (the journey to the USA as a symbol for the search for identity, which largely leaves out the political background). This tendency—finding one's identity by traveling to America—is noticeable in literature by East German authors from the 1990s, one of whom is Angela Krauß. In many of her works, particularly in her novels Die Überfliegerin (1995) and Milliarden neuer Sterne (1999), travel to America is a catalyst for the narrator experiencing her own identity in relation to past experiences, specifically her life in East German society. The exploration of the new world manifests itself in these texts as a discovery of the narrator's inner self.
Sophie von La Roche's America novel, Erscheinungen am See Oneida (Phenomena at Lake Oneida, 1798), centers on a French aristocratic couple from Flanders who go to live on a remote island in upstate New York. Carl and Emilie von Wattines have fled to the United States from the French revolutionary Terror, in which several of their relatives lost their lives. On advice from a Quaker friend in Philadelphia, they find their way to an island in Oneida Lake. There they live without contact with other Europeans for four years, producing two children and making a modest life for themselves, before moving to a new town founded by Dutch and German settlers on the lakeshore. A narrator traveling in the region pieces their story together from what he learns from them and their friends. At the crux of the tale is how the Wattineses, Crusoe-like, manage to survive in their isolation.
Three factors play a role. First, in spite of being aristocrats, they possess a bourgeois ethic, demonstrating qualities like modesty, hard work, and resourcefulness that help them to thrive. Second, they have brought a whole library of reference books with them, including the entire Encyclopédie and Buffon's Histoire naturelle, to which they frequently refer for how-to information. Finally and most interestingly, Emilie Wattines decides to reach out and make contact with the local indigenous people, the Oneidas, when she is about to give birth.
In recent years, the works by the German-Jewish poet Gertrud Kolmar (1894–1943) have found renewed interest among scholars. Raised in the upper middle class of Berlin and fully acculturated in the German cultural heritage, Gertrud Kolmar was persecuted, under the pressure of the National Socialist regime, because of her Jewish roots. Unlike many of her contemporaries, she chose to remain in Nazi Berlin and continued to write until her death in Auschwitz in 1943. Even though her published work spanned the innovative period between 1917 and 1937, Kolmar's poetic oeuvre from the years 1927 to 1937 has received the most attention. Though neglected by scholars, Kolmar's earlier work is fascinating precisely because it gives prescient insight into her poetic adaptations of questions concerning place, power, and gender at the end of the First World War.
My essay investigates an early poem in Kolmar's work: “Die Aztekin” (The Aztec Woman), written around 1920 and published in Früher Zyklus I. In memoriam 1918. Kolmar's “Aztekin” illustrates a testing ground for colonial fantasies and gendered mappings in its imaginary space of a poetic “Aztec empire.” The poem responds not only to preestablished writings on gendered conquests in the New World but also, more specifically, rewrites them in the perceived context of an imperial apocalypse in and after 1918, between megalomaniacal power struggles and the collapse of the Wilhelmine empire.
Swiss photojournalist and author Annemarie Schwarzenbach was born in 1908 into the family of the wealthy Swiss silk manufacturer Alfred Schwarzenbach and his wife Renée Schwarzenbach-Wille and died under tragic circumstances in 1942. Schwarzenbach's life was marked by her travels to the United States, the Orient, Africa, and through Europe. In this context, during her lifetime Schwarzenbach gained recognition for her travel writing and journalism within Switzerland. For example, her work was regularly published in Zürcher Illustrierte, National-Zeitung, Luzerner Tagblatt, Thurgauer Zeitung, and the journal ABC. As recent scholarship has emphasized, “her travel writings consist of a wide range of genres: from journalistic reportages and feuilletons to stories, novels, and also poems. In addition to her journalistic and travel writing, Schwarzenbach also produced several novels and novellas that thematize same-sex relationships as well as the blurring of gender lines, such as Eine Frau zu sehen (written in 1929, published in 2008), Pariser Novelle (written in 1929, published in 2003), Freunde um Bernhard (1931), and Tod in Persien (1936), among others. This last work also reflects her travels to the Near East. Schwarzenbach's androgynous and striking physical beauty, her homosexuality, travels, and drug abuse, as well as her encounters, friendships, and liaisons with famous contemporaries, made her in public and scholarly discourses into something of an icon. This icon status and the “clear autobiographical dimension” in her work fueled biographical scholarly approaches to Schwarzenbach's oeuvre after its rediscovery in 1987 (Schwelle, 404) after “her name [had] faded into obscurity” following her death.
November 5, 1853. Ida Pfeiffer, an Austrian traveler, is on her way to a village north of Crescent City in California, and the main purpose of her visit to this region is, as she claims, to see Indians. What she finds instead are ethnically hybrid Native Americans:
Nichts erschien mir komischer als die sonderbaren Anzüge, denn auch hier lasen sie alle von den Weißen weggeworfenen Kleidungsstücke auf. So sah ich einen Indianer, welcher ein Beinkleid, eine sehr schadhafte Mantille und einen zerknitterten Frauenhut trug. Ein anderer hatte weiter nichts als einen Frack an, den er nach eigenem Geschmacke auf der Rückseite ganz mit Glasperlen benäht hatte. Ein dritter trug wieder nur eine Weste, dazu einen Männerhut, in welchen er oben ein Loch geschnitten und viele Vogelfedern aufgesteckt hatte. Ebenso geschmackvoll waren die Weiber gekleidet.
[Nothing seemed more comical to me than their strange outfits, for here too they collected all the garments discarded by the whites. I saw an Indian wearing a pair of breeches, a very ragged mantilla, and a crumpled lady's hat. Another one wore nothing but a frock coat, the back of which he had adorned with glass beads according to his own taste. A third one wore only a waistcoat and a man's hat to go with it. On its top he had cut a hole and stuck many feathers into it. The women were dressed in equally good taste.]
In the late nineteenth century, novels by the author “S. Wörishöffer” were best-sellers among young readers, rivaling the works of Karl May in popularity. Although their educational value might be debatable, Wörishöffer's adventure tales, which were set all over the world, seemed to offer the combination of excitement and exoticism that was attractive to young readers. In spite of the books' popularity, however, their readers knew virtually nothing about their author. This was no coincidence; the novelist's identity was a well-kept secret. It was not a globetrotter writing about his own experiences who was hiding behind the pen name “S. Wörishöffer.” Instead, the author lived in Altona near Hamburg and never ventured farther from home than to the East Frisian Islands. In addition, the author was not a man, as the subject matter of the stories might suggest, but a woman—Sophie Wörishöffer. In order to maintain the credibility of her works, Wörishöffer's publisher Velhagen & Klasing consciously hid such details from the public (Klasing, 658).
Nevertheless, Wörishöffer produced at least a dozen exotic adventure novels for the “reifere Knabenwelt” (readership of teenage boys), as many of them were subtitled. Their settings and the travels of their protagonists are not limited to America, but encompass the globe. For example, in her first adventure novel alone, Robert des Schiffsjungen Fahrten und Abenteuer auf der deutschen Handels- und Kriegsflotte (Robert the Cabin Boy's Journeys and Adventures with the German Merchant and Armed Fleet, 1877), Robert travels from Germany to Cuba, the United States, the Arctic Circle, South America, and via North America back to Germany, from whence he then ventures out again.
Gabriele Reuter's textsEpisode Hopkins (1889) and Der Amerikaner (The American, 1907) fall into a historic timeframe that presented German society with the challenge to define itself. Both texts reflect the struggle for a national identity based on a common cultural identity (rather than on an economic collaboration between the wars of 1871 and 1914) and the German state's unilateral position as a tactical outsider to global imperialism. At the time Der Amerikaner was produced, not quite twenty years after the foundation of the German state, the euphoric national climate that united the nation-states against the enemy around the time of the Napoleonic wars at the beginning of the century had faded, and the federal states sought for commonalities in order to stress their national identity. The historian Harold James prominently calls this disposition of the German states a “tortured quest for identity.” The contemporaneous identity crisis, James explains in A German Identity, arose from an attempt of the enemies of political liberalism to install a concept of nationalism based on “the mystical terms of community and, more and more from the 1870s, of race” instead of economic nationalism. This development ultimately lead to “a redefinition of nationality” outside of an economic framework (91). James's analysis explains the political developments that lead to the German crisis of identity, and I argue that such a redefinition shapes the zeitgeist in such a way that it is reflected in fictional works of art.