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This study presents the black hole accretion history of obscured active galactic nuclei (AGNs) identified from the JWST CEERS survey by Chien et al. (2024) using mid-infrared (MIR) SED fitting. We compute black hole accretion rates (BHARs) to estimate the black hole accretion density (BHAD), $\rho_{L_{\text{disk}}}$, across $0 \lt z \lt 4.25$. MIR luminosity functions (LFs) are also constructed for these sources, modeled with modified Schechter and double power law forms, and corresponding BHAD, $\rho_{\text{LF}}$, is derived by integrating the LFs and multiplying by the luminosity. Both $\rho_{\text{LF}}$ extend to luminosities as low as $10^7 \, {\rm L}_{\odot}$, two orders of magnitude fainter than pre-JWST studies. Our results show that BHAD peaks between redshifts 1 and 3, with the peak varying by method and model, $z \simeq$ 1 - 2 for $\rho_{L_{\text{disk}}}$ and the double power law, and $z \simeq$ 2 - 3 for the modified Schechter function. A scenario where AGN activity peaks before cosmic star formation would challenge existing black hole formation theories, but our present study, based on early JWST observations, provides an initial exploration of this possibility. At $z \sim 3$, $\rho_{\text{LF}}$ appears higher than X-ray estimates, suggesting that MIR observations are more effective in detecting obscured AGNs missed by X-ray observations. However, given the overlapping error bars, this difference remains within the uncertainties and requires confirmation with larger samples. These findings highlight the potential of JWST surveys to enhance the understanding of co-evolution between galaxies and AGNs.
The outer solar system is theoretically predicted to harbour an undiscovered planet, often referred to as Planet Nine. Simulations suggest that its gravitational influence could explain the unusual clustering of minor bodies in the Kuiper Belt. However, no observational evidence for Planet Nine has been found so far, as its predicted orbit lies far beyond Neptune, where it reflects only a faint amount of Sunlight. This work aims to find Planet Nine candidates by taking advantage of two far-infrared all-sky surveys, which are IRAS and AKARI. The epochs of these two surveys were separated by 23 years, which is large enough to detect Planet Nine’s $\sim3'$/year orbital motion. We use a dedicated AKARI Far-Infrared point source list for the purpose of our Planet Nine search — AKARI-FIS Monthly Unconfirmed Source List (AKARI-MUSL), which includes sources detected repeatedly only in hours timescale, but not after months. AKARI-MUSL is more advantageous than the AKARI Bright Source Catalogue (AKARI-BSC) for detecting moving and faint objects like Planet Nine with a twice-deeper flux detection limit. We search for objects that moved slowly between IRAS and AKARI detections given in the catalogues. First, we estimated the expected flux and orbital motion of Planet Nine by assuming its mass, distance, and effective temperature to ensure it can be detected by IRAS and AKARI, then applied the positional and flux selection criteria to narrow down the number of sources from the catalogues. Next, we produced all possible candidate pairs including one IRAS source and one AKARI source whose angular separations were limited between 42′ and $69.6'$, corresponding to the heliocentric distance range of 500 – 700 AU and the mass range of 7 – 17M$_{\oplus}$. There are 13 candidate pairs obtained after the selection criteria. After image inspection, we found one good candidate, of which the IRAS source is absent from the same coordinate in the AKARI image after 23 years and vice versa. However, AKARI and IRAS detections are not enough to determine the full orbit of this candidate. This issue leads to the need for follow-up observations, which will determine the Keplerian motion of our Planet Nine candidate.
An unusual orbital element clustering of Kuiper belt objects (KBOs) has been observed. The most promising dynamic solution is the presence of a giant planet in the outer Solar system, Planet Nine. However, due to its extreme distance, intensive searches in optical have not been successful. We aim to find Planet Nine in the far-infrared, where it has the peak of the black body radiation, using the most sensitive all-sky far-infrared survey to date, AKARI. In contrast to optical searches, where the energy of reflected sunlight decreases by $d^{4}$, thermal radiation in the infrared decreases with the square of the heliocentric distance $d^{2}$. We search for moving objects in the AKARI Single Scan Detection List. We select sources from a promising region suggested by an N-body simulation from Millholland and Laughlin 2017: $30^{\circ}\lt$ R.A. $\lt50^{\circ}$ and $-20^{\circ}\lt$ Dec. $\lt20^{\circ}$. Known sources are excluded by cross-matching AKARI sources with 9 optical and infrared catalogues. Furthermore, we select sources with small background strength to avoid sources in the cirrus. Since Planet Nine is stationary in a timescale of hours but moves on a monthly scale, our primary strategy is to select slowly moving objects that are stationary in 24 h but not in six months, using multiple single scans by AKARI. The selected slowly moving AKARI sources are scrutinised for potential contamination from cosmic rays. Our analysis reveals two possible Planet Nine candidates whose positions and flux are within the theoretical prediction ranges. These candidates warrant further investigation through follow-up observations to confirm the existence and properties of Planet Nine.
Brown dwarfs are failed stars with very low mass (13–75 Jupiter mass) and an effective temperature lower than 2 500 K. Their mass range is between Jupiter and red dwarfs. Thus, they play a key role in understanding the gap in the mass function between stars and planets. However, due to their faint nature, previous searches are inevitably limited to the solar neighbourhood (20 pc). To improve our knowledge of the low mass part of the initial stellar mass function and the star formation history of the Milky Way, it is crucial to find more distant brown dwarfs. Using James Webb Space Telescope (JWST) COSMOS-Web data, this study seeks to enhance our comprehension of the physical characteristics of brown dwarfs situated at a distance of kpc scale. The exceptional sensitivity of the JWST enables the detection of brown dwarfs that are up to 100 times more distant than those discovered in the earlier all-sky infrared surveys. The large area coverage of the JWST COSMOS-Web survey allows us to find more distant brown dwarfs than earlier JWST studies with smaller area coverages. To capture prominent water absorption features around 2.7 ${\unicode{x03BC}}$m, we apply two colour criteria, $\text{F115W}-\text{F277W}+1\lt\text{F277W}-\text{F444W}$ and $\text{F277W}-\text{F444W}\gt\,0.9$. We then select point sources by CLASS_STAR, FLUX_RADIUS, and SPREAD_MODEL criteria. Faint sources are visually checked to exclude possibly extended sources. We conduct SED fitting and MCMC simulations to determine their physical properties and associated uncertainties. Our search reveals 25 T-dwarf candidates and 2 Y-dwarf candidates, more than any previous JWST brown dwarf searches. They are located from 0.3 to 4 kpc away from the Earth. The spatial number density of 900–1 050 K dwarf is $(2.0\pm0.9) \times10^{-6}\text{ pc}^{-3}$, 1 050–1 200 K dwarf is $(1.2\pm0.7) \times10^{-6}\text{ pc}^{-3}$, and 1 200–1 350 K dwarf is $(4.4\pm1.3) \times10^{-6}\text{ pc}^{-3}$. The cumulative number count of our brown dwarf candidates is consistent with the prediction from a standard double exponential model. Three of our brown dwarf candidates were detected by HST, with transverse velocities $12\pm5$, $12\pm4$, and $17\pm6$ km s$^{-1}$. Along with earlier studies, the JWST has opened a new window of brown dwarf research in the Milky Way thick disk and halo.
The Olympic Games are burdened with this inherent paradox of universal humanism and chauvinistic nationalism. Japan took palpable national pride in being the first ever Asian host of the modern Olympic Games in 1964 and in executing the mission with zeal, precision and order. Hosting the 2020 Olympics again represents Japan’s aspiration to play a significant role in the global world - and rebranding Tokyo as a leading global city – but this grand scheme has also invoked some antagonistic sentiments at home.
Reflecting on the 70th anniversary of the end of Japan's War, it is worth noting that teaching the history of World War II to Japanese children has always been difficult at best. As a subject fraught with contentions over textbook content and conflict between teachers and state bureaucracy, teaching war history has long been “a dreaded subject” for many school teachers. Japanese history education has been criticized for not going far and deeply enough to describe perpetrator history - especially the injury and death inflicted on tens of millions of Asian victims. At the same time, it has been admonished for the opposite: that it goes too far in promoting Japan's negative self-identity. This contest to shape hearts and minds of future citizens has long burdened Japan's history education in schools, and has yielded mixed results.
Benedict Anderson reminds us that modernity has been characterized by the emergence of nation-states that can mobilize the passion of young men to “die for the country” on a mass scale. Once mobilized, nationalist passion allows a soldier to believe “he is dying for something greater than himself, for something that will outlast his individual, perishable life in place of a greater, eternal vitality.” But after demobilization, this patriotic fervor withers, no longer fed or needed for everyday combat. In peacetime, the fervor that enabled death and destruction for national purpose no longer even has any social or moral legitimacy.
Turbulent transonic buffet is an aerodynamic instability causing periodic (albeit, often irregular) oscillations of lift/drag in aerospace applications. Involving complex coupling between inviscid and viscous effects, buffet is characterised by shock wave oscillations and flow separation/reattachment. Previous studies have identified both two-dimensional (2-D) chordwise shock-oscillation and three-dimensional (3-D) buffet-/stall-cell modes. While the 2-D instability has been studied extensively, investigations of 3-D buffet have been limited to only low-fidelity simulations or experiments. Due to computational cost, almost all high-fidelity studies to date have been limited to narrow span-widths around 5 % of aerofoil chord length (aspect ratio, ), which is insufficiently wide to observe large-scale three-dimensionality. In this work, high-fidelity simulations are performed up to , on an infinite unswept NASA Common Research Model (CRM) wing profile at $Re=5\times 10^{5}$. At , intermittent 3-D separation bubbles are observed at buffet conditions. While previous Reynolds-averaged Navier–Stokes (RANS)/stability-based studies predict quasi-simultaneous onset of 2-D- and 3-D-buffet, a case that remains essentially 2-D is identified here. Strongest three-dimensionality was observed near low-lift phases of the buffet cycle at maximum flow separation, reverting to essentially 2-D behaviour during high-lift phases. Buffet was found to become 3-D when extensive mean flow separation was present. At , multiple 3-D separation bubbles form in a spanwise wavelength range $\lambda =1c$ to $1.5c$. Spectral proper orthogonal decomposition (SPOD) was applied to analyse the spatio/temporal structure of 3-D buffet-cells. In addition to the 2-D chordwise shock-oscillation mode (Strouhal number $St \approx 0.07-0.1$), 3-D modal structures were observed at the shock wave/boundary layer interaction at $St \approx 0.002-0.004$.
Objectives: Domestic squalor (DS) is related to physical problems, living alone, problems for their family and neighbors, and mental illness, the most common of which is dementia. Early intervention for DS is important; however, Methods to detect and treat older adults with DS remain unclear. This study aimed to clarify the Methods of early intervention in older adults with DS.
Methods: The Initial-phase Intensive Support Team for Dementia (IPIST) is a multidisciplinary outreach team that provides intensive initial assessment and support for people living at home with suspected dementia in Japan. We distributed a questionnaire to 50 IPISTs that had reported experience of dealing with many complex cases’’ in our previous nationwide survey, asking them to provide detailed information on two complex cases’’ that were extremely difficult to approach or link to medical or long-term care. The questionnaire consisted of questions regarding sociodemographic characteristics, clinical assessments, referral sources, and reasons for complexity. We compared the results of the questionnaire between cases with and without DS (DS+ vs. DS-) and between cases with DS who lived alone and those who lived with family (DS+ living alone vs. DS+ living withfamily).
Results: We received responses from 33 IPISTs and collected data from 70 complex cases. DS was selected as the reason for complexity in 24 cases. Fourteen DS+ cases lived alone. DS+ cases referred by the family (8.3%) were significantly fewer than DS- cases (54.3%). In DS+ cases, the most common referral sources were neighbors and welfare commissioners. The proportion of cases having self-neglect were significantly more in DS+ (87.5%) than in DS- (13.0%). DS+ cases living alone were significantly younger (mean ± SD; 72.9 ± 7.3) than those living with family (80.0 ± 6.7). Family members living with DS+ cases also had issues including mental illness or maltreatment.
Conclusions: This study revealed that most older adults with DS experience self-neglect and a lack of supportive family members. A comprehensive approach to both older adults with DS and their families is important for early intervention, and therefore IPISTs that have a multidisciplinary team with an outreach function would be useful.
Fast radio bursts (FRBs) are millisecond-duration radio waves from the Universe. Even though more than 50 physical models have been proposed, the origin and physical mechanism of FRB emissions are still unknown. The classification of FRBs is one of the primary approaches to understanding their mechanisms, but previous studies classified conventionally using only a few observational parameters, such as fluence and duration, which might be incomplete. To overcome this problem, we use an unsupervised machine-learning model, the Uniform Manifold Approximation and Projection to handle seven parameters simultaneously, including amplitude, linear temporal drift, time duration, central frequency, bandwidth, scaled energy, and fluence. We test the method for homogeneous 977 sub-bursts of FRB 20121102A detected by the Arecibo telescope. Our machine-learning analysis identified five distinct clusters, suggesting the possible existence of multiple different physical mechanisms responsible for the observed FRBs from the FRB 20121102A source. The geometry of the emission region and the propagation effect of FRB signals could also make such distinct clusters. This research will be a benchmark for future FRB classifications when dedicated radio telescopes such as the square kilometer array or Bustling Universe Radio Survey Telescope in Taiwan discover more FRBs than before.
In schizophrenia (SZ), impairments in cognitive functions, such as working memory, have been associated with alterations in certain types of inhibitory neurons that utilize the neurotransmitter γ-aminobutyric acid (GABA) in the dorsolateral prefrontal cortex (DLPFC). For example, GABA neurons that express parvalbumin (PV) or somatostatin (SST) have more prominent gene expression alterations than those that express vasoactive intestinal peptide (VIP). In bipolar disorder (BD) and major depression (MD), which exhibit similar, but less severe, cognitive impairments than SZ, alterations of transcript levels in GABA neurons have also been reported. However, the extent to which GABA neuron subtype-selective transcripts in the DLPFC are affected, and the relative magnitudes of the diagnosis-associated effects, have not been directly compared across SZ, BD, and MD in the same study.
Methods
We used quantitative polymerase chain reaction to examine levels of GABA neuron subtype-selective transcripts (PV, potassium voltage-gated channel modifier subfamily-S member-3, SST, VIP, and calretinin mRNAs), as well as the pan-GABA neuron marker 67 kDa glutamate decarboxylase mRNA, in DLPFC total gray matter of 160 individuals, including those with SZ, BD, or MD and unaffected comparison (UC) individuals.
Results
Relative to UC individuals, individuals with SZ exhibited large deficits in levels of all transcripts except for calretinin mRNA, whereas individuals with BD or MD showed a marked deficit only for PV or SST mRNAs, respectively.
Conclusions
These findings suggest that broader and more severe alterations in DLPFC GABA neurons might contribute to the greater cognitive impairments in SZ relative to BD and MD.
We aimed to psychometrically evaluate and validate a Japanese version of the Social Functioning in Dementia scale (SF-DEM-J) and investigate changes in social function in people with dementia during the coronavirus disease-19 (COVID-19) pandemic.
Design:
We interviewed people with mild cognitive impairment (MCI) and mild dementia and their caregivers during June 2020–March 2021 to validate patient- and caregiver-rated SF-DEM-J and compared their scores at baseline (April 2020 to May 2020) and at 6–8 months (January 2021 to March 2021) during a time of tighter COVID-19 restrictions.
Setting:
The neuropsychology clinic in the Department of Psychiatry at Osaka University Hospital and outpatient clinic in the Department of Psychiatry and Neurology at Daini Osaka Police Hospital, Japan.
Participants:
103 dyads of patients and caregivers.
Measurements:
SF-DEM-J, Mini-Mental State Examination, Neuropsychiatric Inventory, UCLA Loneliness Scale, and Apathy Evaluation Scale.
Results:
The scale’s interrater reliability was excellent and test–retest reliability was substantial. Content validity was confirmed for the caregiver-rated SF-DEM-J, and convergent validity was moderate. Caregiver-rated SF-DEM-J was associated with apathy, irritability, loneliness, and cognitive impairment. The total score of caregiver-rated SF-DEM-J and the score of Section 2, “communication with others,” significantly improved at 6–8 months of follow-up.
Conclusions:
The SF-DEM-J is acceptable as a measure of social function in MCI and mild dementia. Our results show that the social functioning of people with dementia, especially communicating with others, improved during the COVID-19 pandemic, probably as a result of adaptation to the restrictive life.
This paper examines how unionization affects economic growth through its impact on industry concentration in a two-country model of international trade and endogenous productivity growth. Knowledge spillovers link firm-level productivity in innovation with geographic patterns of industry ensuring a faster rate of output growth when industry is relatively concentrated in the country with the greater labor supply. We show that stronger bargaining power in the relatively large country increases the rate of output growth when labor unions are employment-oriented but decreases the rate of growth when unions are wage-oriented. We then calibrate the model using labor market data for the United Kingdom and France and study the effects of union bargaining power on industry location patterns, output growth, and national welfare.
A 4-component clay-polymer-salt-water system was studied by neutron scattering. The clay-salt-water system consisted of n-butylammonium vermiculite, n-butylammonium chloride and heavy water, and the volume fraction of clay in the system was held constant, at r = 0.01. Three polymers in the molecular weight range 10,000 to 30,000 were studied, poly(vinyl methyl ether) (PVME), poly (ethylene oxide) (PEO) and poly(acrylic acid) (PAA), at a polymer volume fraction of v = 0.01. The addition of PAA suppressed the clay swelling, irrespective of the salt concentration, c. The addition of the neutral polymers had no effect on the phase transition temperature, Tc, between the gel and tactoid phases of the system, its value remaining at 14 °C for c = 0.1 M and 30 °C for c = 0.01 M. At c = 0.01 M, the neutral polymers also had a negligible effect on the lattice constant d along the swelling axis of the clay colloid, but at c = 0.1 M, the d-value was significantly lower than in the system without added polymer. For a PVME sample of molecular weight 18,000, both d and Tc were measured as a function of ν, for volume fractions between 0 and 0.04. The addition of polymer, up to v = 0.04, had no effect on Tc. However, even for v values as low as 0.001, the vermiculite layers in the gel phase were more parallel and more regularly spaced than in the system without added polymer. In the gel phase, d decreased exponentially as a function of v, from 12 nm at v = 0 to 8 nm at v = 0.04. In the tactoid phase, at T < 14 °C, the d-value in the crystalline regions was equal to 1.94 nm at v = 0 and v = 0.04, showing that the spacing between the vermiculite layers is not affected by the added polymer when they are collapsed by an increase in temperature. The addition of a PVME sample of molecular weight 110,000, at v = 0.001, had no noticeable effect on either d or Tc.
Eating problems frequently occur in people with dementia with Lewy bodies (DLB), but few studies have investigated the clinical background of this phenomenon. This study examined the relationship between eating problems and various symptoms of DLB and the relation between the treatment needs for DLB people with eating problems and the understanding of their eating problems by caregivers and physicians.
Design, measurements, and participants:
This was a subanalysis of a cross-sectional, questionnaire-based survey study. Two hundred sixty-one subjects with DLB were divided into subjects with or without eating problems. Logistic or linear regression analysis was used to investigate the factors influencing eating problems. The treatment needs of DLB people for their eating problems and the understanding of these needs by caregivers and physicians were calculated as participant–caregiver and participant–physician kappa coefficient.
Results:
Of the 261 participants, 27% suffered from eating problems. The presence of eating problems in participants with DLB was related to depression (p = 0.01, OR : 2.19, 95% CI: 1.23–3.91) and apathy (p = 0.01, OR 2.15, 95% CI: 1.20–3.87), while the worsening of eating problems was related to dysphagia (β = 0.24, p = 0.03), apathy (β = 0.23, p = 0.05), and nighttime behavior (β = 0.24, p = 0.04). The participant–physician kappa coefficient for physician understanding of constipation, weight loss, dysphagia, weight gain, and increase in appetite was significantly lower than the corresponding participant–caregiver kappa coefficient (p-value of five symptoms < 0.01).
Conclusions:
Physicians need to pay more attention to eating problems and their neuropsychiatric background in the long-term support and management of DLB subjects.
Maternal prenatal and postnatal psychological distress, including depression and anxiety, may affect children’s cognitive development. However, the findings have been inconsistent. We aimed to use the dataset from the Japan Environment and Children’s Study, a nationwide prospective birth cohort study, to examine this association. We evaluated the relationship between the maternal six-item version of the Kessler Psychological Distress Scale (K6) scores and cognitive development among children aged 4 years. K6 was administered twice during pregnancy (M-T1; first half of pregnancy, M-T2; second half of pregnancy) and 1 year postpartum (C-1y). Cognitive development was assessed by trained testers, using the Kyoto Scale of Psychological Development 2001. Multiple regression analysis was performed with the group with a K6 score ≤ 4 for both M-T1 and M-T2 and C-1y as a reference. Records from 1,630 boys and 1,657 girls were analyzed. In the group with K6 scores ≥ 5 in both M-T1 and M-T2 and C-1Y groups, boys had significantly lower developmental quotients (DQ) in the language-social developmental (L-S) area (partial regression coefficient: −4.09, 95% confidence interval: −6.88 – −1.31), while girls did not differ significantly in DQ for the L-S area. Among boys and girls, those with K6 scores ≤ 4 at any one or two periods during M-T1, M-T2, or C-1y did not have significantly lower DQ for the L-S area. Persistent maternal psychological distress from the first half of pregnancy to 1 year postpartum had a disadvantageous association with verbal cognitive development in boys, but not in girls aged 4 years.
Treatment of idiopathic normal-pressure hydrocephalus (iNPH) requires collaboration between dementia specialists and neurosurgeons. The role of dementia specialists is to differentiate patients with iNPH from patients with other dementia diseases and to determine if other dementia diseases are comorbid with iNPH. We conducted a nationwide hospital-based questionnaire survey on iNPH in medical centers for dementia (MCDs).
Methods:
We developed a questionnaire to assess how physicians in MCDs evaluate and treat patients with cognitive impairment due to suspected iNPH and the difficulties these physicians experience in the evaluation and treatment of patients. The questionnaire was sent to all 456 MCDs in Japan.
Results:
Questionnaires from 279 MCDs were returned to us (response rate: 61.2%). Patients underwent cognitive tests, evaluation of the triad symptoms of iNPH, and morphological neuroimaging examinations in 96.8, 77.8, and 98.2% of the MCDs, respectively. Patients with suspected iNPH were referred to other hospitals (e.g., hospitals with neurosurgery departments) from 78.9% of MCDs, and cerebrospinal fluid (CSF) tap test was performed in 44 MCDs (15.8%). iNPH guidelines (iNPHGLs) and disproportionately enlarged subarachnoid space hydrocephalus (DESH), a specific morphological finding, were used and known in 39.4% and 38% of MCDs, respectively. Logistic regression analysis with “Refer the patient to other hospitals (e.g., hospitals with neurosurgery departments) when iNPH is suspected.” as the response variable and (a) using the iNPHGLs, (b) knowledge of DESH, (c) confidence regarding DESH, (d) difficulty with performing brain magnetic resonance imaging, (e) knowledge of the methods of CSF tap test, (f) absence of physician who can perform lumbar puncture, and (g) experience of being told by neurosurgeons that referred patients are not indicated for shunt surgery as explanatory variables revealed that the last two factors were significant predictors of patient referral from MCDs to other hospitals.
Conclusion:
Sufficient differential or comorbid diagnosis using CSF tap test was performed in a few MCDs. Medical care for patients with iNPH in MCDs may be improved by having dementia specialists perform CSF tap tests and share the eligibility criteria for shunt surgery with neurosurgeons.
Although the previous studies indicated that impaired cerebrospinal fluid (CSF) dynamics might contribute to the pathophysiology of Alzheimer’s disease (AD), the longitudinal changes of CSF volumes in AD has been still unclear. In this study, using the methodology of quantitative assessment of CSF volumes in idiopathic normal pressure hydrocephalus (iNPH), we assessed longitudinal changes in CSF volumes in AD patients.
Methods:
The subjects were the patients with mild cognitive impairment and dementia due to AD who visited Osaka University Hospital from November 2009 to October 2018. We excluded the patients with gait disturbances and MRI findings such as Disproportionately enlarged subarachnoid-space hydrocephalus (DESH), which was the suggestive finding of iNPH. For each subject, MRI was performed in the first visit and 1 year later. We quantitatively measured CSF volumes in DESH-related regions, such as ventricle systems (VS), Sylvian fissures (SF), and sulci at high convexity and the midline (SHM)., using an automatic brain volumetric software program (AVSIS) (Ishii et al. 2006, 2013). The ratio of each regional volume to the intracranial volume was calculated and we compared these parameters between two visits.
Results:
We enrolled 98 patients with AD (mean (SD) age = 76.0 (5.7)). Wilcoxon signed rank test revealed that, while the ratios of CSF volumes in VS and SF significantly increased during the one-year observation (VS: 4.01 (1.05) % vs 4.14 (1.09) %, p<0.001 ;SF: 1.40 (0.21) % vs 1.42 (0.22) %, p=0.007), those in SHM significantly decreased (4.30 (0.70) % vs 4.23 (0.69) %, p<0.001). The change ratio of relative volumes in VS was correlated with those in SF and SHM (r=0.451, p<0.001; r=-0.350, p<0.001).
Conclusion:
In patients with AD, the CSF volumes in VS and SF increased while CSF volumes in SHM decreased. This trend of the longitudinal change was similar to the change in the patients with iNPH. The finding of this study indicates that, in the patients with AD, CSF dynamics may be impaired like the patients with iNPH.
We have reported parkinsonism and psychiatric symptoms were the most important treatment needs of patients with dementia with Lewy bodies (DLB) and their caregivers, respectively 1). However, the frequency presenting clinical symptoms and the onset time vary among patients. We investigated the impact of the disease duration on clinical symptoms, prescribed medication and treatment needs of patients and their caregivers.
Methods:
Disease duration was defined as time after diagnosis with DLB. Patient-caregiver pairs were classified into two groups; one with a disease duration <24 months (S-group) and the other with a disease duration ≥24 months (L-group). Comparisons were made between two groups regarding background characteristics and treatment needs of patients and caregivers. Treatment needs were defined as symptom domains most distressing to patients and caregivers.
Results:
S-group and L-group were consisted of 126 and 137 pairs of patients and their caregivers, respectively. Regarding patientsʼ current symptoms, parkinsonism and autonomic dysfunction were significantly higher in L-group than S-group. MDS-UPDRS Part III total score and the frequency of prescription for memantine and antiparkinsonian were also significantly higher in L-group than in S- group. The treatment needs most frequently selected by patients was cognitive impairment (20.6%) followed by autonomic dysfunction (16.7%) and parkinsonism (11.9%) in S-group, and parkinsonism (24.6%), followed by cognitive impairment and autonomic dysfunction (11.1% each) in L-group, suggesting no significant difference in the tendency of symptom domains to desire treatment between groups (P=0.056). However, residual analysis showed that patients in S-group were more likely to select cognitive impairment than in L-group (P=0.045), and those in L-group were more likely to select parkinsonism than in S-group (P=0.003). The treatment needs most frequently selected by caregivers in S-group was cognitive impairment (29.4%) followed by psychiatric symptoms (20.6%) and parkinsonism (10.3%) in S-group, and psychiatric symptoms (24.6%), followed by parkinsonism (16.7%) and cognitive impairment (14.3%) in L-group, suggesting significant difference in the tendency of patientsʼ symptom domains to desire treatment between groups (P=0.032). Dara from the onset will be added at the poster presentation.
Conclusion:
It was suggested that the treatment needs of patients and their caregivers might change with duration after diagnosis.