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Non-marine molluscs stand out as the major animal group under the most severe threat. Among the 8664 mollusc species evaluated for the IUCN Red List (version 2019-1), 300 are considered Extinct out of a total 872 listed Extinct species. However, only ~10% of molluscs have been evaluated and other assessments of the number of extinct species are much higher, 3000 to over 5000, almost exclusively non-marine species. As for most other groups, threats faced by non-marine molluscs are habitat loss, probably the most important, but also impacts of introduced species, exploitation, generally of less concern, and climate change, likely to have serious effects into the future. Oceanic island species, often narrowly endemic, are especially threatened and constitute a high proportion of recorded extinctions. Anthropogenic activities have caused non-marine mollusc extinctions since prehistory, but threats have increased greatly over the last few centuries and will probably continue to increase. Most mollusc species for which a population trend has been evaluated by IUCN are stable or declining; those few that are increasing are primarily introduced and invasive. Most threatened are oceanic island snails, North American and other freshwater bivalves, and the diverse and highly endemic micro-snails of Southeast Asian limestone outcrops.
Liquid-phase transmission electron microscopy is a technique for simultaneous imaging of the structure and dynamics of specimens in a liquid environment. The conventional sample geometry consists of a liquid layer tightly sandwiched between two Si3N4 windows with a nominal spacing on the order of 0.5 μm. We describe a variation of the conventional approach, wherein the Si3N4 windows are separated by a 10-μm-thick spacer, thus providing room for gas flow inside the liquid specimen enclosure. Adjusting the pressure and flow speed of humid air inside this environmental liquid cell (ELC) creates a stable liquid layer of controllable thickness on the bottom window, thus facilitating high-resolution observations of low mass-thickness contrast objects at low electron doses. We demonstrate controllable liquid thicknesses in the range 160 ± 34 to 340 ± 71 nm resulting in corresponding edge resolutions of 0.8 ± 0.06 to 1.7 ± 0.8 nm as measured for immersed gold nanoparticles. Liquid layer thickness 40 ± 8 nm allowed imaging of low-contrast polystyrene particles. Hydration effects in the ELC have been studied using poly-N-isopropylacrylamide nanogels with a silica core. Therefore, ELC can be a suitable tool for in situ investigations of liquid specimens.
Behavioral and psychological symptoms of dementia (BPSD), constitute a major clinical component of Alzheimer’s disease (AD). There is a growing interest in BPSD as they are responsible for a large share of the suffering of patients and caregivers, and they strongly determine the patient’s lifestyle and management. Better detection and understanding of these symptoms is essential to provide appropriate management. This article is a consensus produced by the behavioral group of the European Alzheimer’s Disease Consortium (EADC). The aim of this article is to present clinical description and biological correlates of the major behavioral and psychological symptomatology in AD. BPSD is not a unitary concept. Instead, it should be divided into several symptoms or more likely: groups of symptoms, each possibly reflecting a different prevalence, course over time, biological correlate and psychosocial determinants. There is some clinical evidence for clusters within groups of BPSD. Biological studies indicate that patients with AD and BPSD are associated with variations in the pathological features (atrophy, brain perfusion/metabolism, histopathology) when compared to people with AD without BPSD. An individually tailored approach taking all these aspects into account is warranted as it may offer more, and better, pharmacological and non-pharmacological treatment opportunities.
Although non-drug interventions are widely used in patients with Alzheimer's disease, few large scale randomized trials involving a long-term intervention and several cognitive-oriented approaches have been carried out. ETNA3 trial compares the effect of cognitive training, reminiscence therapy, and an individualized cognitive rehabilitation program in Alzheimer's disease to usual care.
This is a multicenter (40 French clinical sites) randomized, parallel-group trial, with a two-year follow-up comparing groups receiving standardized programs of cognitive training (group sessions), reminiscence therapy (group sessions), individualized cognitive rehabilitation program (individual sessions), and usual care (reference group). Six hundred fifty-three outpatients with Alzheimer's disease were recruited. The primary efficacy outcome was the rate of survival without moderately severe to severe dementia at two years. Secondary outcomes were cognitive impairment, functional disability, behavioral disturbance, apathy, quality of life, depression, caregiver's burden, and resource utilization.
No impact on the primary efficacy measure was evidenced. For the two group interventions (i.e. cognitive training and reminiscence), none of the secondary outcomes differed from usual care. The larger effect was seen with individualized cognitive rehabilitation in which significantly lower functional disability and a six-month delay in institutionalization at two years were evidenced.
These findings challenge current management practices of Alzheimer's patients. While cognitive-oriented group therapies have gained popularity, this trial does not show improvement for the patients. The individualized cognitive rehabilitation intervention provided clinically significant results. Individual interventions should be considered to delay institutionalization in Alzheimer's disease.
While it is well known that posttraumatic stress disorder (PTSD) is characterized by heterogeneous symptom clusters, little is known about predominant typologies of PTSD symptoms in older adults.
Latent profile analyses (LPAs) were employed to evaluate predominant typologies of PTSD symptoms in a sample of 164 treatment-seeking older adults with childhood war-related trauma. Multinomial logistic regressions were conducted to evaluate predictors of class membership.
LPAs revealed that a 3-class solution best fit the data. These included an Intermediate Disturbance class (50.0%) and two Pervasive Disturbance classes, which differed with respect to severity of avoidance symptoms (Pervasive Disturbance-Low Avoidance: 33.5%, Pervasive Disturbance-High Avoidance: 16.5%). A greater number of traumatic events predicted membership in the Pervasive Disturbance classes. The Pervasive Disturbance-Low Avoidance class had a higher level of education than the Pervasive Disturbance-High Avoidance class. Compared to the Intermediate Disturbance class, the Pervasive Disturbance classes had the highest levels of depression, anxiety and somatization symptoms.
These results suggest that PTSD in treatment-seeking older adults may be characterized by three predominant typologies, which are differentiated by overall severity and avoidance symptoms, lifetime trauma burden, education level, and comorbid depression, anxiety, and somatization symptoms. These results underscore the importance of considering heterogeneity in the phenotypic presentation of PTSD in assessment and treatment approaches for this disorder in older adults.
The target adopted by world leaders of significantly reducing the rate of biodiversity loss by 2010 was not met but this stimulated a new suite of biodiversity targets for 2020 adopted by the Parties to the Convention on Biological Diversity (CBD) in October 2010. Indicators will be essential for monitoring progress towards these targets and the CBD will be defining a suite of relevant indicators, building on those developed for the 2010 target. Here we argue that explicitly linked sets of indicators offer a more useful framework than do individual indicators because the former are easier to understand, communicate and interpret to guide policy. A Response-Pressure-State-Benefit framework for structuring and linking indicators facilitates an understanding of the relationships between policy actions, anthropogenic threats, the status of biodiversity and the benefits that people derive from it. Such an approach is appropriate at global, regional, national and local scales but for many systems it is easier to demonstrate causal linkages and use them to aid decision making at national and local scales. We outline examples of linked indicator sets for humid tropical forests and marine fisheries as illustrations of the concept and conclude that much work remains to be done in developing both the indicators and the causal links between them.
This chapter talks about a 70-year-old woman who consulted for a severe cognitive complaint encompassing numerous domains. MRI showed no focal atrophy especially of the hippocampal regions. The initial diagnostic impression was a subjective cognitive complaint with an attention disorder of probable psychogenic origin. Subjective cognitive complaint (SCC) is frequent in normal aging with a prevalence of 50% after 55 years of age. Episodic memory is the capacity to recall personal events that can be identified in time or in space. Memory disorders in everyday life can result from attention disorders, retrieval difficulties as well as genuine memory deficit due to Alzheimer's disease. The best way to disentangle the diagnostic problem is to assess memory by objective tests that may control for attention and that can facilitate the retrieval. This is the case of the Free and Cued Selected Recall Test (FCSRT).
The science of extra-solar planets is one of the most rapidly changing areas of astrophysics and since 1995 the number of planets known has increased by almost two orders of magnitude. A combination of ground-based surveys and dedicated space missions has resulted in 560-plus planets being detected, and over 1200 that await confirmation. NASA's Kepler mission has opened up the possibility of discovering Earth-like planets in the habitable zone around some of the 100,000 stars it is surveying during its 3 to 4-year lifetime. The new ESA's Gaia mission is expected to discover thousands of new planets around stars within 200 parsecs of the Sun. The key challenge now is moving on from discovery, important though that remains, to characterisation: what are these planets actually like, and why are they as they are?
In the past ten years, we have learned how to obtain the first spectra of exoplanets using transit transmission and emission spectroscopy. With the high stability of Spitzer, Hubble, and large ground-based telescopes the spectra of bright close-in massive planets can be obtained and species like water vapour, methane, carbon monoxide and dioxide have been detected. With transit science came the first tangible remote sensing of these planetary bodies and so one can start to extrapolate from what has been learnt from Solar System probes to what one might plan to learn about their faraway siblings. As we learn more about the atmospheres, surfaces and near-surfaces of these remote bodies, we will begin to build up a clearer picture of their construction, history and suitability for life.
The Exoplanet Characterisation Observatory, EChO, will be the first dedicated mission to investigate the physics and chemistry of Exoplanetary Atmospheres. By characterising spectroscopically more bodies in different environments we will take detailed planetology out of the Solar System and into the Galaxy as a whole.
EChO has now been selected by the European Space Agency to be assessed as one of four M3 mission candidates.
The Supernova Working Group was re-established at the IAU XXV General Assembly in Sydney, 21 July 2003, sponsored by Commissions 28 (Galaxies) and 47 (Cosmology). Here we report on some of its activities since 2005.
David Ames, Professor of Psychiatry of Old Age, University of Melbourne,
Eleanor Flynn, Senior Lecturer in Medical Education, University of Melbourne,
Maria Alekxandrova, Associate Professor of Psychiatry, Medical University Pleven,
Kaloyan Stoychev, Consultant Psychiatrist, University Hospital Pleven,
Kenneth Shulman, Professor of Geriatric Psychiatry, University of Toronto,
Ross Upshur, Professor of Primary Care, University of Toronto,
Kirsten Abelskov, Old-Age Psychiatrist, Aarhus University Hospital,
Kaj Sparle Christensen, General Practitioner, Institut for Almen Medicin, University of Aarhus,
Philippe H. Robert, Professor of Psychiatry,
Michel Benoit, Psychiatrist Centre Mémoire de Ressources et de Recherche, Nice,
Florence Cabane, General Practitioner Nice,
Geneviève Ruault, Geriatrician Nice,
Helen F. K. Chiu, Professor of Psychiatry, The Chinese University of Hong Kong,
D. K. T. Li, Family Physician, Past President Hong Kong College of Family Physicians,
Syuichi Awata, Psychiatrist and Director Division of Neuropsychiatry and Center for Dementia, Sendai City Hospital,
Akira Honma, Psychiatrist, Tokyo Metropolitan Institute of Gerontology,
Els Licht-Strunk, General Practitioner, VU University Medical Centre, Amsterdam,
Marijke Bremmer, Consultant Psychiatrist, VU University Medical Centre, Amsterdam,
Knut Engedal, Professor of Old-Age Psychiatry, Ullevaal University Hospital, Oslo,
Harald Sanaker, Specialist in Family Medicine, Kongsvegen Legesenter, Brummunddal,
Nicoleta Tătaru, Senior Consultant Psychiatrist, Forensic Hospital Ştei, Bihor,
Monica Bălan, Primary Care Physician Oradea,
Alexandru Dicker, Senior Consultant in Internal Medicine Psychiatric Hospital, Nucet, Bihor,
Raimundo Mateos, Professor of Psychiatry, University of Santiago de Compostela,
Jose Antonio Ferreiro Guri, Specialist in Family and Community, Medicine University of Santiago de Compostela,
Tom Campbell, Professor of Family Medicine, University of Rochester, NY,
Jeffrey M. Lyness, Professor of Psychiatry, University of Rochester, NY
The editors summarized the contributions written by colleagues in different parts of the world (Chapter 6) to illustrate the similarities, and occasional differences, in the management of depression in older people described in all the contributions. This appendix allows the reader to read the individual contributions.
This 82-year-old woman is chronically disabled by pain and breathlessness and appears to have become socially disengaged. She has several symptoms of depression, including persistent low mood, loss of energy (which sounds to be out of proportion to her medical state), early morning waking, loss of interest in previously enjoyed activities, and persistent feelings that life is not worth living. The vignette does not provide information about her appetite and weight, concentration, any psychomotor changes, guilt feelings or confidence levels, but even so it is clear that, provided the symptoms have been present for two weeks (and this seems highly likely), she meets both DSM-IV diagnostic criteria for a major depressive episode and ICD-10 criteria for a depressive episode.
Australian health-care system
Within the Australian health-care system, in which specialists are accessible only after referral from a general practitioner (GP), this woman would normally be managed by her GP who in all likelihood will already be engaged in the management of her troublesome osteoarthritis and chronic obstructive pulmonary disease (COPD). She might well attend a respiratory outpatient clinic or rheumatology clinic in a public hospital, or (less likely as fewer than one-third of the elderly have private health insurance) be seeing a private medical specialist with expertise in one or both of these two areas.
Nutrigenomics is the study of how constituents of the diet interact with genes, and their products, to alter phenotype and, conversely, how genes and their products metabolise these constituents into nutrients, antinutrients, and bioactive compounds. Results from molecular and genetic epidemiological studies indicate that dietary unbalance can alter gene–nutrient interactions in ways that increase the risk of developing chronic disease. The interplay of human genetic variation and environmental factors will make identifying causative genes and nutrients a formidable, but not intractable, challenge. We provide specific recommendations for how to best meet this challenge and discuss the need for new methodologies and the use of comprehensive analyses of nutrient–genotype interactions involving large and diverse populations. The objective of the present paper is to stimulate discourse and collaboration among nutrigenomic researchers and stakeholders, a process that will lead to an increase in global health and wellness by reducing health disparities in developed and developing countries.
Background: Activities of daily living (ADL) deficits are integral components of dementia disorders, and ADL measures are among the most robust markers of the course of Alzheimer's disease (AD). Despite this acknowledged importance, no clearly useful ADL instrument for cross-cultural application in pharmacologic trials in the early stages of AD had been available. Method: An international effort was launched to develop an ADL scale for pharmacologic trials in early AD. Steps taken from 1990 to the present included: (1) international scientific working group meetings and reviews, (2) reviews of existing measures, (3) collating of existent, nonredundant items, (4) querying experts for new items, (5) interviews with informants and subjects in the USA, France, and Germany, toward the identification of potential new items, (6) identification of an item pool based upon these procedures, (7) creation of a trial instrument, (8) piloting of this instrument, and (9) refinement of the scale based upon statistical analysis of the pilot data. Final item selection was based upon: (1) relevance for ≥ 80% of subjects in severity-stratified USA and German samples; (2) absence of gender and national biases; (3) significant (p < .05) discrimination between (a) normal versus mildly impaired and (b) mildly impaired versus moderately to moderately severely impaired subjects; and (4) Global Deterioration Scale (GDS) scores accounting for ≥ 12% of variance in the item after controlling for age and gender. Results: An ADL scale consisting of 40 items that correlate with the global and cognitive progress of AD is developed for international usage in pharmacologic trials in incipient, mild, moderate, and moderately severe AD. The scale contains 40 items falling within 13 ADL categories. The 40-item scale is shown to have .81 correlation with GDS staging,.81 with mental status assessment (Mini-Mental State Examination), and .81 with a psychometric test (the SKT) (p values < .001). Conclusion: This scale can be used to measure therapeutic response in AD.
Verbal fluency tasks are frequently used in clinical
neuropsychology. Clustering (the production of words within
semantic subcategories) and switching (the ability to shift
between clusters) have been described as 2 components underlying
fluency performance. We compared the use of clustering
and switching in schizophrenic patients and healthy subjects.
Seventy-eight schizophrenic subjects (DSM–IV criteria)
and 64 control participants matched for age and educational
level were recruited. Negative, disorganized, and productive
clinical dimensions were evaluated using the SANS and SAPS
scales. The number of words generated per semantic–phonemic
cluster and the number of switches were evaluated during
2 verbal fluency tasks (phonemic and semantic). In the
healthy controls switching and clustering were closely
related to the total number of words generated in the verbal
fluency tests. The role of the 2 components was partly
dependent on the specific task. Switching was prevalent
in formal fluency, while both switching and clustering
contributed to semantic fluency. In comparison to the healthy
controls, the overall group of schizophrenic patients showed
a significant impairment of switching in the formal fluency
task and of both switching and clustering in the semantic
fluency task, and both the negative and disorganized dimensions
correlated with verbal fluency performance, the number
of switches during the phonemic fluency task, and the clustering
during semantic fluency task. (JINS, 1998, 4,
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