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Background: Studies have examined the effects of anti-dementia drugs on gait performance. No structured critical evaluation of these studies has been done so far. The objectives of this study were (1) to perform a qualitative analysis of all published studies on changes in stride time variability (STV) with anti-dementia drugs among patients with Alzheimer disease through a systematic review, and (2) to quantitatively synthesize anti-dementia drug-related changes in STV. Methods: An English and French MEDLINE search was conducted on November 2013, with no limit of date, using the Medical Subject Headings term 'pharmaceutical preparations' combined with 'delirium', 'dementia', 'amnestic', 'cognitive disorders' AND 'gait' OR 'gait disorders, neurologic' OR 'gait apraxia'. Fixed-effects meta-analyses were performed to compare STV before and after the use of anti-dementia drugs, and to compare the final STV among participants in intervention and control groups. Results: Of the 110 originally identified abstracts, four studies (i.e., one assessing galantamine, one donepezil, one memantine, and one memantine and acetylcholinesterase inhibitors) were included in the qualitative review, and three studies in the quantitative synthesis. Results were mixed, as two studies showed significant between-visit improvements (i.e., decrease in mean value) in STV, while one study did not, and the last one reported mixed results. In the meta-analysis, there was no difference between intervention and control groups (summary mean difference of final STV = −0.38 % [95 % confidence interval −1.14 to 0.37]) and no before-after difference in the intervention group (summary mean difference of STV = 0.66 [95 % confidence interval −0.17 to 1.49]). Conclusions: Our findings showed inconclusive effects of anti-dementia drugs on STV. [ABSTRACT FROM AUTHOR]

In order to facilitate measurements of ultrasonic velocity and attenuation, we have developed an automated version of the phase sensitive technique with quadrature detection. The technique is outlined and the precision of relative transit time or velocity measurements that can be obtained from it is analyzed. We describe the computer-controlled experimental setup and report relative velocity and attenuation results obtained on a single crystal of pure KZnF3 . The temperature dependence of the elastic constants C11 and C44 calculated from these results agree very well with that obtained from echo overlap measurements performed on the same crystal. The relative error on the present velocity measurements is Δv/v∼10-5 . [ABSTRACT FROM AUTHOR]

Background: With the rapid growth of elderly patients visiting the Emergency Department (ED), it is expected that there will be even more hospitalisations following ED visits in the future. The aim of this study was to examine the age effect on the performance criteria of the 10- item brief geriatric assessment (BGA) for the prolonged length of hospital stay (LHS) using artificial neural networks (ANNs) analysis.Methods: Based on an observational prospective cohort study, 1117 older patients (i.e., aged H 65 years) ED users were admitted to acute care wards in a University Hospital (France) were recruited. The 10-items of BGA were recorded during the ED visit and prior to discharge to acute care wards. The top third of LHS (i.e., H 13 days) defined the prolonged LHS. Analysis was successively performed on participants categorized in 4 age groups: aged H 70, H 75, H 80 and H 85 years. Performance criteria of 10-item BGA for the prolonged LHS were sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV], likelihood ratios [LR], area under receiver operating characteristic curve [AUROC]). The ANNs analysis method was conducted using the modified multilayer perceptron (MLP). Results: Values of criteria performance were high (sensitivity> 89%, specificityH 96%, PPV > 87%, NPV > 96%, LR+ > 22; LR- X 0.1 and AUROC> 93), regardless of the age group. Conclusions: Age effect on the performance criteria of the 10-item BGA for the prediction of prolonged LHS using MLP was minimal with a good balance between criteria, suggesting that this tool may be used as a screening as well as a predictive tool for prolonged LHS. [ABSTRACT FROM AUTHOR]

Background and purpose Motoric cognitive risk ( MCR) syndrome is a pre-dementia syndrome. There is little information on the cognitive profile of individuals with MCR syndrome and its overlap with mild cognitive impairment ( MCI) syndrome. This study aimed to examine and compare the cognitive performance of non-demented older community dwellers with and without MCR and MCI syndromes. Methods A total of 291 non-demented individuals were selected from the Gait and Alzheimer Interactions Tracking study, which is a cross-sectional study. All participants were referred to a memory clinic. Individuals with and without MCR were separated into those with and without MCI. Cognitive performance was measured using the scores of the Mini Mental Status Examination, Frontal Assessment Battery, Free and Cued Selective Reminding Test, Trail Making Test part A and B, and Stroop test. Results The prevalence of MCI was 40.1% and that of MCR was 18.2%, with a higher prevalence of MCI in MCR group compared with the non- MCR group (47.2% vs. 39.5%). Individuals with MCR and MCI syndromes had poorer cognitive performance in all domains compared with those without MCR ( P < 0.005), except for the ratio part III: part I of the Stroop test ( P = 0.345). The association between cognitive performance and MCR syndrome was worse on the Mini Mental Status Examination score [effect size, −0.57 (95% confidence interval, −1.02 to −0.12)] and Trail Making Test part B [effect size, 0.59 (95% confidence interval, 0.14-1.04)] in individuals with MCR and MCI syndromes. Conclusions Motoric cognitive risk syndrome is associated with low global cognitive performance. Association of MCR and MCI syndromes is characterized by a worse cognitive performance. [ABSTRACT FROM AUTHOR]

La remédiation cognitive (RC) est une approche brève et focalisée favorisant un meilleur fonctionnement neuropsychologique et une meilleure qualité de vie. Les processus neuropsychologiques ciblés concernent les fonctions exécutives ; l'attention et la cognition sociale. En intervention précoce la RC vise à éviter un surhandicap chez les enfants et les adolescents présentant un trouble du neurodéveloppement en prévenant aussi des complications émotionnelles et/ou comportementales associées. Elle complète les prises en charge habituelles ou les optimise. Concernant la cognition sociale, elle favorise le développement de la théorie de l'esprit et protège d'une faiblesse de l'inhibition comportementale. Facteur de réhabilitation chez les adultes, la RC est facteur d'inclusion chez les plus jeunes et favorise le maintien dans leur environnement écologique. Nous proposons le programme de remédiation cognitive NEAR (Neuropsychological Educational Approach to Remediation), développé depuis 2002 par Alice Medalia, à des collégiens avec trouble du spectre de l'autisme (TSA) ou Trouble déficit de l'attention avec ou sans hyperactivité (TDA/H). Outil thérapeutique attractif pour les plus jeunes il a fait preuve de son intérêt chez les adultes ; intègre la métacognition et optimise la généralisation dans la vie quotidienne. La réalisation d'un bilan médical et neuropsychologique au C3RP-Enfants/Adolescents (Centre référent en remédiation cognitive et réhabilitation psycho-sociale) est un prérequis et les bénéfices sont évalués au terme du programme. Dans une étude de faisabilité, les jeunes ont témoigné se sentir plus motivés, confiants et compétents. La RC semble représenter une nouvelle ressource thérapeutique pour les plus jeunes dont l'efficience reste à évaluer scientifiquement. Cognitive remediation is a brief and focused therapeutic approach for adults, children or adolescents with cognitive impairments as observed in psychiatric disorders. Executive functioning, social cognition and attention are the main dimensions trained with specific programs. Metacognition is also targeted and contributes to a better quality of life and to better adaptation in daily life. For children and adolescents the objective of cognitive remediation is to maintain the subject in his or her ecological environment (family, school, leisure). Neuropsychological dimensions, such as executive functions, attention, and social cognition are the targets of varied programs. Cognitive remediation helps to avoid over-handicap and may prevent some emotional and behavioral complications. The scientific background for cognitive remediation consists of studies involving the schizophrenic population, and cerebral plasticity is the basis of the theory. Different steps are described by researchers, distinguishing cognitive training (step 1) and adaptation in daily life (step 4). Cognitive training is a bottom-up approach, and daily life adaptation is a top-down approach as described by neuropsychological theories. For adults with schizophrenia, cognitive remediation acts on specific neuropsychological dimensions of hypofrontality. For children and adolescents presenting neurodevelopmental disorders such as autism or ADHD, attention, flexibility and inhibition are targets for therapy. And for emotional disorders such as anxiety, or for depressive disorders, even if there is a paucity of programs and studies, we have the knowledge that attentional bias as identified by cognitive-behavioral therapies can be modified. Despite this knowledge for emotional disorders there are insufficient studies about the validation of the cognitive remediation approach for children and adolescents. A special cognitive remediation program was developed by Alice Medalia for adults with schizophrenia. We thus developed a program for adolescents with ASD or ADHD. It is administered through an outpatient platform which associates computerized sessions of cognitive remediation and bridging groups that help adolescents to generalize the cognitive benefits of those sessions to daily life. Adolescents receive medical, psychological and neuropsychological evaluation at the beginning of the program, and benefits are evaluated at the end of the program. Thirty sessions are proposed, and each session has a mean duration of 75 mn: 40 mn of cognitive exercises and 35 mn of bridging group. The objective of the bridging group is the generalization of the cognitive exercises to daily life. During each session, the computerized program adjusts to the young subject's performances. The therapist gives support in order to provide a positive learning experience. Adolescents reported feeling more motivated, confident and competent as a result of participating in the program. Cognitive remediation facilitates inclusion of young people in their ecological environment, such as school. Cognitive remediation is a brief and focused approach which is supported by the cerebral plasticity hypothesis. The optimization of executive functions, cognitive and social-cognitive dimensions is an objective that can be applied to many psychiatric disorders in children and adolescents. It is a promising tool for treating these young subjects even if more studies on its efficacy are needed. [ABSTRACT FROM AUTHOR]

Background and purpose: Cognitive impairment, slow walking speed and motoric cognitive risk syndrome (MCR) have separately been associated with an increased risk for mortality in the short term. The aim of the study was to examine the association of MCR and its components [i.e. subjective cognitive complaint (SCC) and slow walking speed] with short‐, medium‐ and long‐term mortality in older community‐dwellers. Methods: In all, 3778 participants from the Epidémiologie de l'Ostéoporose (EPIDOS) study were selected. MCR was defined as the combination of slow walking speed and SCC in participants without major neurocognitive disorders. Deaths were prospectively recorded using mail, phone calls, questionnaires and/or the French national death registry at 5, 10, 15 and 19 (end of follow‐up period) years. Results: Over the follow‐up of 19 years, 80.5% (n = 3043) participants died. Slow walking speed and MCR were associated with mortality [hazard ratio (HR) 1.20 with P = 0.004 for slow walking speed and HR = 1.26 with P = 0.002 for MCR at 10 years; HR = 1.27 with P ≤ 0.001 for slow walking speed and HR = 1.22 with P = 0.001 for MCR at 15 years; HR = 1.41 with P ≤ 0.001 at 19 years for slow walking speed and MCR]. There was no association between SCC and mortality. Kaplan–Meier distributions of mortality showed that participants with MCR and slow walking speed died earlier compared to healthy participants and those with SCC (P < 0.001). Conclusions: Slow walking speed and MCR were associated with an increased risk for mortality at the medium and long term, whereas no association was found with SCC. [ABSTRACT FROM AUTHOR]

Following the Paris agreement in 2015, the European Union (EU) set a carbon neutrality objective by 2050, and so did France. The French agricultural sector can contribute as a carbon sink through carbon storage in biomass and soil, in addition to reducing GHG emissions. The objective of this study is to quantitatively assess the additional storage potential and cost of a set of eight carbon-storing practices. The impacts of these agricultural practices on soil organic carbon storage and crop production are assessed at a very fine spatial scale, using crop and grassland models. The associated area base, GHG budget, and implementation costs are assessed and aggregated at the region level. The economic model BANCO uses this information to derive the marginal abatement cost curve for France and identify the combination of carbon storing practices that minimizes the total cost of achieving a given national net GHG mitigation target. We find that a substantial amount of carbon, 36.2 to 52.9 MtCO 2 e yr−1, can be stored in soil and biomass for reasonable carbon prices of 55 and 250 € tCO 2 e−1, respectively (corresponding to current and 2030 French carbon value for climate action), mainly by developing agroforestry and hedges, generalising cover crops, and introducing or extending temporary grasslands in crop sequences. This finding questions the 3–5 times lower target of 10 MtCO2e.yr−1 retained for the agricultural carbon sink by the French climate neutrality strategy. Overall, this would decrease total French GHG emissions by 9.2–13.8%, respectively (reference year 2019). • Additional carbon storage, net GHG budget, and cost of 8 agricultural practices. • MACC shows abatement potential of 40–60 MtCO 2 e.yr−1 for carbon price 55–250 €.tCO 2 e−1. • Key practices: agroforestry, hedges, cover crops, grasslands in crop sequences. • No "one size fits all strategy" due to heterogeneity across regions and practices. • French agricultural carbon sink potential is 5 times higher than anticipated by the government. [ABSTRACT FROM AUTHOR]

Résumé La remédiation cognitive (RC) est une nouvelle approche thérapeutique dont le postulat repose sur l’hypothèse de la plasticité cérébrale permettant ainsi à des sujets présentant des défaillances cognitives spécifiques d’améliorer leurs fonctions exécutives ainsi que leur qualité de vie. Des programmes ont été appliqués et validés chez des adultes présentant un trouble schizophrénique et sont à l’origine du développement de programmes dédiés aux enfants présentant divers troubles psychiatriques pour lesquels des dysfonctionnements exécutifs ont été repérés. C’est le cas des enfants présentant un trouble du spectre autistique, un trouble déficit de l’attention/hyperactivité (TDA/H) ou encore une anorexie mentale. Le centre hospitalier Sainte-Anne qui a créé un centre de référence de remédiation et de réhabilitation psychosociale (C3RP) a développé, en parallèle de prises en charge destinées aux adultes, des programmes destinés aux enfants présentant des troubles du développement. Inspirés de programmes validés, français et anglo-saxons, la méthode associe des tâches papier-crayon et des jeux de société pour optimiser les fonctions d’attention, de mémorisation, de planification et de flexibilité mentale chez des enfants présentant un TDA/H ou des troubles des apprentissages. Ce programme, mené en parallèle de programmes classiques de prise en charge, témoigne dans une étude de faisabilité de sa bonne acceptation par l’enfant et sa famille ainsi que d’un impact positif sur les fonctions exécutives même si ce résultat demande à être répliqué. Summary The hypothesis of cerebral plasticity in psychiatric disorders has encouraged clinicians to develop cognitive remediation therapy (CRT), a new therapeutic approach based on attention, memory, planning, and mental flexibility tasks. The first cognitive remediation programs were developed and validated for adults with schizophrenia and were shown to have a positive impact on executive functions as well as on quality of life. In children and adolescents, researchers emphasized the existence of executive dysfunction in neurodevelopmental disorders such as autistic spectrum disorder, attention deficit disorder, and eating disorders. For these disorders, neuropsychological studies suggest that memory, planning, attention and mental flexibility are impaired. Despite the paucity of studies on cognitive remediation (CR) in children, preliminary results have suggested, as in adults with schizophrenia, good compliance and optimization of executive functioning. Consequently, programs dedicated to young subjects were developed in English-speaking countries, and the Department of Child and Adolescent Psychiatry of Sainte Anne Hospital (Paris) developed a new CR program for children with attention deficit disorder, academic problems, or eating disorders. These programs complete the field of CRT proposed by Sainte Anne Hospital's Remediation and Psychosocial Rehabilitation Reference Center, initially designed for adults with schizophrenia. Our team used and adapted validated tools such as Delahunty and Wykes's CRT program (translated and validated in French by Amado and Franck) and Lindvall and Lask's CRT Resource Pack. One program was developed for an adolescent with anorexia nervosa and applied to the subject and her family, but the purpose of this paper is to present a CR approach for children with attention deficit disorder or academic disorder, a 6-month program based on paper-pencil tasks and board and card games. The team was trained in different kinds of cognitive remediation, and the program was applied by a clinical nurse with the supervision of a child and adolescent psychiatrist and the department's neuropsychologists. Paper-pencil tasks were adapted from the CRT program for adults; the card and board games used were geometric figures, illusions, Rush Hour ® , Set ® , Jungle Speed ® , Color Addict ® , etc. These games are available in stores and the program can be applied at home, which helps families set aside their preoccupations with their child's academic performance. Diagnostic and neuropsychological evaluations were done before the beginning of the therapy and repeated at the end of the 6-month program. This program does not ignore the metapsychological impact of the therapy, and work on self-esteem is also done. The presence of the therapist is necessary, which seems better than a computer program, which cannot encourage the young subject in the same personalized and empathetic way. We therefore conducted the first clinical feasibility trial of cognitive remediation in young subjects and present a clinical case of a 6-year-old boy with attention deficit disorder and academic disorder. The results of neuropsychological evaluations before and after therapy suggest improvement in executive functions and better self-esteem. Satisfaction for the boy and his family was high. Even if these results need to be replicated, cognitive remediation appears to be a new therapeutic tool, complementary to classical approaches used in childhood psychiatric disorders. The Department of Child and Adolescent Psychiatry will submit this program to a research program conducted by the National Health Department to study the impact of this approach in a controlled study. [ABSTRACT FROM AUTHOR]

Sequential feeding (SF) is an innovative system for laying hens consisting of nutrients separating energy, protein, and calcium supplies to fulfill nutrient requirements at the relevant time of day. In previous studies, hens received whole wheat in the morning and a balancer diet (rich in protein and calcium) in the afternoon. To improve SF utilization, the aim was to substitute whole wheat in the morning by an alternative energy supply: ground wheat and ground corn, with or without a proportion of whole wheat and insoluble fiber. The goal was to obtain the advantages observed in previous experiments with whole wheat [bigger gizzard, thinner hens, reduced feed conversion ratio (FCR)]. Four hundred thirty-two ISA Brown hens were housed in collective cages from 20 to 35 wk of age divided into 8 different treatments: a continuous control diet, a sequential diet with whole wheat in the morning, 3 wheat-based diets (ground wheat, ground wheat and 20% whole wheat, and ground wheat with 5% insoluble fiber) and 3 ground corn-based (ground corn, ground corn and 20% whole wheat, and ground corn with 5% insoluble fiber) provided in the morning. All sequential regimens received the same balancer diet rich in protein and calcium in the afternoon. Whole wheat SF gave the best results with an improved FCR compared with continuous control and all other SF diets. Wheat- and corn-based diets showed intermediate results between whole wheat SF and continuous feeding. Gizzard weight was higher and hens were lighter than with conventional continuous feeding, leading to an average FCR improvement of 3.2% compared with a continuous control. Thus, it is possible in SF diets to substitute, at least partially, whole wheat by ground wheat or ground corn with added insoluble fiber or some whole wheat, allowing more flexibility and economic optimization. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: In cases of agitation and aggressive behavior after severe traumatic brain injury (TBI), the benefits/risks ratio of pharmacological treatments remains unclear. A qualitative analysis of clinical situations could highlight the relevance of psychotherapy care. Case report: In January 2005, this 24-year-old patient sustained severe traumatic brain injury (Glasgow at 4/15), with bilateral frontotemporal injury and temporal extradural hematoma. On the third day, a temporal lobectomy was performed. The patient''s evolution showed severe neurobehavioral disorders, with agitation and aggressive behavior towards family members and medical caregivers. Maximum doses of antipsychotic drugs brought no improvement. Antidepressant medication improved social contact. Several stays in the psychiatric unit, where institutionalized and psychotherapy care were implemented, showed systematically a real improvement of the behavioral disorders, increased participation in group activities and the ability to walk around alone in a closed environment. Discussion/conclusion: Aggressive behavior can unveil organic brain injuries, depressive syndrome as well as iatrogenic nature of the environment. This clinical case is based on the fact that antipsychotic drugs, aside from their sedative effect, are not the proper treatment for agitation following traumatic brain injury. This case also highlights how management of behavioral disorders following TBI should not be based on pharmacological treatments only but instead should focus on multidisciplinary strategies of care. [Copyright &y& Elsevier]

Background and purpose To validate a Short Form of the Mini- Mental State Examination ( SMMSE) as a screening test for dementia in older ambulatory individuals followed in a memory clinic for a memory complaint. Methods A total of 202 cognitively healthy individuals, 100 individuals with a mild cognitive impairment and 304 demented individuals sent for a memory complaint by their primary care physician to a memory clinic were prospectively included in this cross-sectional study. They were randomized into derivation ( n = 303) and validation ( n = 303) groups. The SMMSE score was built from six memory items of MMSE, with a score ranging from 0 to 6 (i.e. best performance). Results The receiver operating characteristic curve showed an area under the curve of 0.98 for the derivation group and 0.97 for the validation group without differences between curves ( P = 0.254). The cut-off between the sensitivity and the specificity of the SMMSE score for clinically diagnosed dementia was ≤4. The performance of the SMMSE for the diagnosis of dementia was high in the derivation and validation groups: sensitivity at 93.1% and 93.8%, specificity at 93.8% and 90.5%, positive predictive value at 94.3% and 90.1%, negative predictive value at 92.5% and 94.0%, likelihood ratio of positive test at 14.9 and 9.8 and of negative test at 0.07 and 0.07, respectively. Conclusions The Short Form of the Mini- Mental State Examination was a good screening test for dementia in older individuals followed in a memory clinic for a memory complaint. The next step should be the confirmation of its discriminative value in older primary care patients. [ABSTRACT FROM AUTHOR]