Background
A Task Force was convened by the EFNS/MDS‐ES Scientist Panel on Parkinson's disease (PD) and other movement disorders to systemically review relevant publications on the diagnosis of PD.
...Methods
Following the EFNS instruction for the preparation of neurological diagnostic guidelines, recommendation levels have been generated for diagnostic criteria and investigations.
Results
For the clinical diagnosis, we recommend the use of the Queen Square Brain Bank criteria (Level B). Genetic testing for specific mutations is recommended on an individual basis (Level B), taking into account specific features (i.e. family history and age of onset). We recommend olfactory testing to differentiate PD from other parkinsonian disorders including recessive forms (Level A). Screening for pre‐motor PD with olfactory testing requires additional tests due to limited specificity. Drug challenge tests are not recommended for the diagnosis in de novo parkinsonian patients. There is an insufficient evidence to support their role in the differential diagnosis between PD and other parkinsonian syndromes. We recommend an assessment of cognition and a screening for REM sleep behaviour disorder, psychotic manifestations and severe depression in the initial evaluation of suspected PD cases (Level A). Transcranial sonography is recommended for the differentiation of PD from atypical and secondary parkinsonian disorders (Level A), for the early diagnosis of PD and in the detection of subjects at risk for PD (Level A), although the technique is so far not universally used and requires some expertise. Because specificity of TCS for the development of PD is limited, TCS should be used in conjunction with other screening tests. Conventional magnetic resonance imaging and diffusion‐weighted imaging at 1.5 T are recommended as neuroimaging tools that can support a diagnosis of multiple system atrophy (MSA) or progressive supranuclear palsy versus PD on the basis of regional atrophy and signal change as well as diffusivity patterns (Level A). DaTscan SPECT is registered in Europe and the United States for the differential diagnosis between degenerative parkinsonisms and essential tremor (Level A). More specifically, DaTscan is indicated in the presence of significant diagnostic uncertainty such as parkinsonism associated with neuroleptic exposure and atypical tremor manifestations such as isolated unilateral postural tremor. Studies of 123IMIBG/SPECT cardiac uptake may be used to identify patients with PD versus controls and MSA patients (Level A). All other SPECT imaging studies do not fulfil registration standards and cannot be recommended for routine clinical use. At the moment, no conclusion can be drawn as to diagnostic efficacy of autonomic function tests, neurophysiological tests and positron emission tomography imaging in PD.
Conclusions
The diagnosis of PD is still largely based on the correct identification of its clinical features. Selected investigations (genetic, olfactory, and neuroimaging studies) have an ancillary role in confirming the diagnosis, and some of them could be possibly used in the near future to identify subjects in a pre‐symptomatic phase of the disease.
Click here for the corresponding questions to this CME article.
Jupiter's atmosphere is rotating differentially, with zones and belts rotating at speeds that differ by up to 100 metres per second. Whether this is also true of the gas giant's interior has been ...unknown, limiting our ability to probe the structure and composition of the planet. The discovery by the Juno spacecraft that Jupiter's gravity field is north-south asymmetric and the determination of its non-zero odd gravitational harmonics J
, J
, J
and J
demonstrates that the observed zonal cloud flow must persist to a depth of about 3,000 kilometres from the cloud tops. Here we report an analysis of Jupiter's even gravitational harmonics J
, J
, J
and J
as observed by Juno and compared to the predictions of interior models. We find that the deep interior of the planet rotates nearly as a rigid body, with differential rotation decreasing by at least an order of magnitude compared to the atmosphere. Moreover, we find that the atmospheric zonal flow extends to more than 2,000 kilometres and to less than 3,500 kilometres, making it fully consistent with the constraints obtained independently from the odd gravitational harmonics. This depth corresponds to the point at which the electric conductivity becomes large and magnetic drag should suppress differential rotation. Given that electric conductivity is dependent on planetary mass, we expect the outer, differentially rotating region to be at least three times deeper in Saturn and to be shallower in massive giant planets and brown dwarfs.
ABSTRACT
We present the first asteroseismic results for δ Scuti and γ Doradus stars observed in Sectors 1 and 2 of the TESS mission. We utilize the 2-min cadence TESS data for a sample of 117 stars ...to classify their behaviour regarding variability and place them in the Hertzsprung–Russell diagram using Gaia DR2 data. Included within our sample are the eponymous members of two pulsator classes, γ Doradus and SX Phoenicis. Our sample of pulsating intermediate-mass stars observed by TESS also allows us to confront theoretical models of pulsation driving in the classical instability strip for the first time and show that mixing processes in the outer envelope play an important role. We derive an empirical estimate of 74 per cent for the relative amplitude suppression factor as a result of the redder TESS passband compared to the Kepler mission using a pulsating eclipsing binary system. Furthermore, our sample contains many high-frequency pulsators, allowing us to probe the frequency variability of hot young δ Scuti stars, which were lacking in the Kepler mission data set, and identify promising targets for future asteroseismic modelling. The TESS data also allow us to refine the stellar parameters of SX Phoenicis, which is believed to be a blue straggler.
Toxoplasma gondii, an obligate intracellular parasite of the phylum Apicomplexa, has the unusual ability to infect virtually any warm-blooded animal. It is an extraordinarily successful parasite, ...infecting an estimated 30% of humans worldwide. The outcome of Toxoplasma infection is highly dependent on allelic differences in the large number of effectors that the parasite secretes into the host cell. Here, we show that the largest determinant of the virulence difference between two of the most common strains of Toxoplasma is the ROP5 locus. This is an unusual segment of the Toxoplasma genome consisting of a family of 4-10 tandem, highly divergent genes encoding pseudokinases that are injected directly into host cells. Given their hypothesized catalytic inactivity, it is striking that deletion of the ROP5 cluster in a highly virulent strain caused a complete loss of virulence, showing that ROP5 proteins are, in fact, indispensable for Toxoplasma to cause disease in mice. We find that copy number at this locus varies among the three major Toxoplasma lineages and that extensive polymorphism is clustered into hotspots within the ROP5 pseudokinase domain. We propose that the ROP5 locus represents an unusual evolutionary strategy for sampling of sequence space in which the gene encoding an important enzyme has been (i) catalytically inactivated, (ii) expanded in number, and (iii) subject to strong positive selection. Such a strategy likely contributes to Toxoplasma's successful adaptation to a wide host range and has resulted in dramatic differences in virulence.
ABSTRACT
Asteroseismology is a powerful tool to infer fundamental stellar properties. The use of these asteroseismic-inferred properties in a growing number of astrophysical contexts makes it vital ...to understand their accuracy. Consequently, we performed a hare-and-hounds exercise where the hares simulated data for six artificial main-sequence stars and the hounds inferred their properties based on different inference procedures. To mimic a pipeline such as that planned for the PLATO mission, all hounds used the same model grid. Some stars were simulated using the physics adopted in the grid, others a different one. The maximum relative differences found (in absolute value) between the inferred and true values of the mass, radius, and age were 4.32, 1.33, and 11.25 per cent, respectively. The largest systematic differences in radius and age were found for a star simulated assuming gravitational settling, not accounted for in the model grid, with biases of −0.88 per cent (radius) and 8.66 per cent (age). For the mass, the most significant bias (−3.16 per cent) was found for a star with a helium enrichment ratio outside the grid range. Moreover, an ∼7 per cent dispersion in age was found when adopting different prescriptions for the surface corrections or shifting the classical observations by ±1σ. The choice of the relative weight given to the classical and seismic constraints also impacted significantly the accuracy and precision of the results. Interestingly, only a few frequencies were required to achieve accurate results on the mass and radius. For the age the same was true when at least one l = 2 mode was considered.
The Hymenoptera Genome Database (HGD) is a comprehensive model organism database that caters to the needs of scientists working on insect species of the order Hymenoptera. This system implements ...open-source software and relational databases providing access to curated data contributed by an extensive, active research community. HGD contains data from 9 different species across ~200 million years in the phylogeny of Hymenoptera, allowing researchers to leverage genetic, genome sequence and gene expression data, as well as the biological knowledge of related model organisms. The availability of resources across an order greatly facilitates comparative genomics and enhances our understanding of the biology of agriculturally important Hymenoptera species through genomics. Curated data at HGD includes predicted and annotated gene sets supported with evidence tracks such as ESTs/cDNAs, small RNA sequences and GC composition domains. Data at HGD can be queried using genome browsers and/or BLAST/PSI-BLAST servers, and it may also be downloaded to perform local searches. We encourage the public to access and contribute data to HGD at: http://HymenopteraGenome.org.
Context. Determining the mass of stars is crucial both for improving stellar evolution theory and for characterising exoplanetary systems. Asteroseismology offers a promising way for estimating the ...stellar mean density. When combined with accurate radii determinations, such as are expected from Gaia, this yields accurate stellar masses. The main difficulty is finding the best way to extract the mean density of a star from a set of observed frequencies. Aims. We seek to establish a new method for estimating the stellar mean density, which combines the simplicity of a scaling law while providing the accuracy of an inversion technique. Methods. We provide a framework in which to construct and evaluate kernel-based linear inversions that directly yield the mean density of a star. We then describe three different inversion techniques (SOLA and two scaling laws) and apply them to the Sun, several test cases and three stars, α Cen B, HD 49933 and HD 49385, two of which are observed by CoRoT. Results. The SOLA (subtractive optimally localised averages) approach and the scaling law based on the surface correcting technique described by Kjeldsen et al. (2008, ApJ, 683, L175) yield comparable results that can reach an accuracy of 0.5% and are better than scaling the large frequency separation. The reason for this is that the averaging kernels from the two first methods are comparable in quality and are better than what is obtained with the large frequency separation. It is also shown that scaling the large frequency separation is more sensitive to near-surface effects, but is much less affected by an incorrect mode identification. As a result, one can identify pulsation modes by looking for an ℓ and n assignment which provides the best agreement between the results from the large frequency separation and those from one of the two other methods. Non-linear effects are also discussed, as is the effects of mixed modes. In particular, we show that mixed modes bring little improvement to the mean density estimates because of their poorly adapted kernels.
ABSTRACT
Asteroseismic forward modelling techniques are being used to determine fundamental properties (e.g. mass, radius, and age) of solar-type stars. The need to take into account all possible ...sources of error is of paramount importance towards a robust determination of stellar properties. We present a study of 34 solar-type stars for which high signal-to-noise asteroseismic data are available from multiyear Kepler photometry. We explore the internal systematics on the stellar properties, that is associated with the uncertainty in the input physics used to construct the stellar models. In particular, we explore the systematics arising from (i) the inclusion of the diffusion of helium and heavy elements; (ii) the uncertainty in solar metallicity mixture; and (iii) different surface correction methods used in optimization/fitting procedures. The systematics arising from comparing results of models with and without diffusion are found to be 0.5 per cent, 0.8 per cent, 2.1 per cent, and 16 per cent in mean density, radius, mass, and age, respectively. The internal systematics in age are significantly larger than the statistical uncertainties. We find the internal systematics resulting from the uncertainty in solar metallicity mixture to be 0.7 per cent in mean density, 0.5 per cent in radius, 1.4 per cent in mass, and 6.7 per cent in age. The surface correction method by Sonoi et al. and Ball & Gizon’s two-term correction produce the lowest internal systematics among the different correction methods, namely, ∼1 per cent, ∼1 per cent, ∼2 per cent, and ∼8 per cent in mean density, radius, mass, and age, respectively. Stellar masses obtained using the surface correction methods by Kjeldsen et al. and Ball & Gizon’s one-term correction are systematically higher than those obtained using frequency ratios.
Studies of exposure to petroleum (crude oil/fuel) often involve monitoring benzene, toluene, ethylbenzene, xylenes (BTEX), and styrene (BTEXS) because of their toxicity and gas-phase prevalence, ...where exposure is typically by inhalation. However, BTEXS levels in the general U.S. population are primarily from exposure to tobacco smoke, where smokers have blood levels on average up to eight times higher than nonsmokers. This work describes a method using partition theory and artificial neural network (ANN) pattern recognition to classify exposure source based on relative BTEXS and 2,5-dimethylfuran blood levels. A method using surrogate signatures to train the ANN was validated by comparing blood levels among cigarette smokers from the National Health and Nutrition Examination Survey (NHANES) with BTEXS and 2,5-dimethylfuran signatures derived from the smoke of machine-smoked cigarettes. Classification agreement for an ANN model trained with relative VOC levels was up to 99.8% for nonsmokers and 100.0% for smokers. As such, because there is limited blood level data on individuals exposed to crude oil/fuel, only surrogate signatures derived from crude oil and fuel were used for training the ANN. For the 2007–2008 NHANES data, the ANN model assigned 7 out of 1998 specimens (0.35%) and for the 2013–2014 NHANES data 12 out of 2906 specimens (0.41%) to the crude oil/fuel signature category.
PDF
