There are currently no Food and Drug Administration-approved treatments for frontotemporal lobar degeneration (FTLD). The objectives of this study were to explore the tolerability of memantine ...treatment in FTLD and to monitor for possible effects on behavior, cognition, and function. Forty-three individuals who met clinical criteria for FTLD 21 with frontotemporal dementia (FTD), 13 with semantic dementia (SD), and 9 with progressive nonfluent aphasia (PA) received 26 weeks of open-label treatment with memantine at a target dose of 20 mg daily. Concurrent treatment with acetylcholinesterase inhibitors was prohibited. Cognitive and functional outcome measures included the Mini Mental State Examination, Alzheimer's Disease Assessment Scale-Cognitive (ADAS-cog), clinical dementia rating-sum of boxes, Neuropsychiatric Inventory (NPI), Frontal Behavior Inventory, Executive Interview (EXIT25), Texas Functional Living Scale (TFLS), Geriatric Depression Scale, and Unified Parkinson's Disease Rating Scale-motor scale. Most subjects were able to tolerate the target dose of memantine. A transient improvement was observed on the total NPI score primarily in the FTD group. Variable declines were observed on the ADAS-cog, EXIT25, Frontal Behavior Inventory, NPI, TFLS, and UPDRS scores. The FTD and SD groups declined on most of the cognitive and behavioral outcome measures, but remained stable on the UPDRS, whereas the progressive nonfluent aphasia group remained relatively stable on the ADAS-cog, NPI, and TFLS, but declined on the UPDRS. Memantine was well-tolerated in these subjects. Future placebo-controlled trials of memantine in FTLD are warranted and may have greater power to detect behavioral and cognitive effects if focused on the FTD and SD clinical syndromes.
This book is about the doing and experiencing of diagnosis in everyday life. Diagnoses are revealed as interactive negotiations rather than as the assigning of diagnostic labels. The authors ...demonstrate, through detailed discourse analyses, how the diagnostic process depends on power and accountability as expressed through the talk of those engaged in the diagnostic process. The authors also show that diagnostic decisions are not only made by professional experts trained in the art and science of diagnosis, but they can also be made by anyone trying to figure out the nature of everyday problems. Finally, diagnostic reasoning is found to extend beyond typical diagnostic situations, occurring in unexpected places such as written letters of recommendation and talk about the nature of communication. Together, the chapters in this book demonstrate how diagnosis is a communication practice deeply rooted in our culture. The book is interdisciplinary and unusually broad in its focus. The authors come from different experiential scholarly backgrounds. Each of them takes a different look at the impact and nature of the diagnostic process. The diagnoses discussed include autism, Alzheimers disease, speech and language disorders, and menopause. The focus is not only on the here and now of the diagnostic interaction, but also on how diagnoses and diagnostic processes change over time. The book can serve as an undergraduate or graduate text for courses offered in various disciplines, including communication, sociology, anthropology, communication disorders, audiology, linguistics, medicine, and disability studies.
Alzheimer's disease (AD) is a chronic, disabling, eventually fatal condition that affects approximately 4 million adults in the United States. The purpose of this qualitative study was to explore ...several issues from the caregiver's perspective: the experience of having a family member diagnosed with AD, participating in a dementia evaluation program, and complying with that program's recommendations. Interview data from 18 family members revealed (a) a pivotal event led to medical intervention, (b) obtaining the diagnosis was a surprise, and (c) dementia evaluation program recommendations were in place at least marginally 6 months after diagnosis. These caregivers desire assistance from healthcare professionals regarding recommendationsfor appropriate and routine medical and social support and follow-up care. As the population ages and the incidence of AD increases, the perspective of caregivers who make healthcare decisions becomes increasingly important.
There are currently no FDA-approved treatments for frontotemporal lobar degeneration (FTLD). The objectives of this study were to explore the tolerability of memantine treatment in FTLD and to ...monitor for possible effects on behavior, cognition and function. 43 individuals who met clinical criteria for FTLD (21 with frontotemporal dementia FTD, 13 with semantic dementia SD and 9 with progressive nonfluent aphasia PA) received 26 weeks of open label treatment with memantine at a target dose of 20 mg daily. Concurrent treatment with acetylcholinesterase inhibitors was prohibited. Cognitive and functional outcome measures included the MMSE, ADAS-cog, CDR-sum of boxes, NPI, Frontal Behavior Inventory (FBI), Executive Interview (EXIT25), Texas Functional Living Scale (TFLS), Geriatric Depression Scale (GDS) and UPDRS-motor scale. Most subjects were able to tolerate the target dose of memantine. A transient improvement was observed on the total NPI score primarily in the FTD group. Variable declines were observed on the ADAS-cog, EXIT25, FBI, NPI, TFLS and UPDRS scores. The FTD and SD groups declined on most of the cognitive and behavioral outcome measures, but remained stable on the UPDRS, whereas the PA group remained relatively stable on the ADAS-cog, NPI and TFLS, but declined on the UPDRS. Memantine was well tolerated in these subjects. Future placebo-controlled trials of memantine in FTLD are warranted and may have greater power to detect behavioral and cognitive effects if focused on the FTD and SD clinical syndromes.
In recent years, there has been increasing interest in the role of lymphatics in organ repair and regeneration, due to their importance in immune surveillance and fluid homeostasis. Experimental ...approaches aimed at boosting lymphangiogenesis following myocardial infarction in mice, were shown to promote healing of the heart. Yet, the mechanisms governing cardiac lymphatic growth remain unclear. Here, we identify two distinct lymphatic populations in the hearts of zebrafish and mouse, one that forms through sprouting lymphangiogenesis, and the other by coalescence of isolated lymphatic cells. By tracing the development of each subset, we reveal diverse cellular origins and differential response to signaling cues. Finally, we show that lymphatic vessels are required for cardiac regeneration in zebrafish as mutants lacking lymphatics display severely impaired regeneration capabilities. Overall, our results provide novel insight into the mechanisms underlying lymphatic formation during development and regeneration, opening new avenues for interventions targeting specific lymphatic populations.
The Earth surface Mineral dust source InvesTigation (EMIT) is a remote visible to shortwave infrared (VSWIR) imaging spectrometer that has been operating onboard the International Space Station since ...July 2022. This article describes EMIT's on-orbit spectroradiometric calibration and validation. Accurate spectroscopy is vital to achieve consistent mapping results with orbital imaging spectrometers. EMIT takes a unique approach to this challenge, with just six optical elements, no shutter, and no onboard calibration systems. Its simple design focuses on uniformity and stability to enable vicarious spectroradiometric calibration. Our experiments demonstrate that this approach is successful, approaching the fidelity of manual field spectroscopy in some cases, and enabling new and more accurate products across diverse Earth science disciplines. EMIT achieves several notable firsts for an instrument of its class. It demonstrates successful on-orbit adjustments of Focal Plane Array (FPA) alignment with sub-micron precision. It offers spectral uniformity better than 98%. Optical artifacts in the measurement channels are at least three orders of magnitude below the primary solar-reflected surface signals. Its noise performance enables percent-level discrimination in the depths of mineral absorption features. In these aspects, EMIT satisfies the stringent performance needs for the next generation of VSWIR imaging spectrometers to observe the Earth's ecosystems, geology, and water resources.
•The EMIT imaging spectrometer a VSWIR imaging spectrometer onboard the International Space Station.•We assess instrument performance and calibration accuracy.•EMIT offers 98% spatial uniformity and high radiometric precision.
This volume is a collection of papers written by several researchers that have in common the use of bio-inspired models to approach formal and natural languages. The main goal of the volume is to ...promote interdisciplinarity among linguistics, biology and computation. The area of convergence between these three disciplines is giving rise to the emergence of new scientific paradigms that will have an epistemological, social and cultural impact. The book is organized around three thematic area.
How did architects get to be architects in any given period in history? How were they trained? How did they find their clients and communicate with them? What did society think of them?. Spiro ...Kostof's The Architect, a collection of essays by historians and architects, explores these and other intriguing questions about the profession of architecture. The first book in more than fifty years to survey the profession from its beginnings in ancient Egypt to the modern day, it is the most complete synthesis to date of our knowledge of how the architect's profession developed. Included are a major study of the Beaux-Arts, a vivid memoir by the distinguished architect Josephy Esherick, and an excellent chapter on women which demostrates how the ethic of professionalism has contributed to the exploitation of women in this as in many other professions. The Architect places the current dilemma about the architect's role in society in historical perspective and offers a good overview of the development of one of the world's oldest professions.
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