Catecholamine-Based Treatment in AD Patients: Expectations and Delusions.

In Alzheimer disease, the gap between excellence of diagnostics and efficacy of therapy is wide. Despite sophisticated imaging and biochemical markers, the efficacy of available therapeutic options is limited. Here we examine the possibility that assessment of endogenous catecholamine levels in cerebrospinal fluid (CSF) may fuel new therapeutic strategies. In reviewing the available literature, we consider the effects of levodopa, monoamine oxidase inhibitors, and noradrenaline (NE) modulators, showing disparate results. We present a preliminary assessment of CSF concentrations of dopamine (DA) and NE, determined by HPLC, in a small dementia cohort of either Alzheimer's disease (AD) or frontotemporal dementia patients, compared to control subjects. Our data reveal detectable levels of DA, NE in CSF, though we found no significant alterations in the dementia population as a whole. AD patients exhibit a small impairment of the DA axis and a larger increase of NE concentration, likely to represent a compensatory mechanism. While waiting for preventive strategies, a pragmatic approach to AD may re-evaluate catecholamine modulation, possibly stratified to dementia subtypes, as part of the therapeutic armamentarium

Intimate Partner Violence Prevention and Intervention at a Primary Care Clinic

Abstract Intimate partner violence (IPV) is a massive health concern in the Spanish-speaking community. There is a high rate IPV, worsening by factors such as language barriers, cultural stigma, and the constant fear of deportation. Resent data underscores the need for standardized IPV screening and trauma-informed care, thus supporting early recognition and intervention. The aim of this Quality Improvement (QI) project is to increase IPV detection rate by 25% from March 10, 2025, to April 15, 2025, in an San Francisco community clinic using an electronic tool called a HITS (Hurt, Insult, Threaten, Scream) and by trauma-informed staff training. Methods of the intervention are integrated hard stops for IPV screening into the electronic health record in EPIC, staff trauma informed IPV care, pamphlets on IPV awareness, and a hosted training session attended by 28 staff members in person, and on zoom. Outcome measures include the number of patients screened, the number of staff trained, the improvements in patient documentation and referrals. The results displayed 42% in staff feeling confident while speaking to patients about IPV while enhancing EPIC documentation for Spanish-speaking patients. However, with these new implementations, barriers such as time constraints, and discomfort from staff were recognized, thus highlighting further implementations that may need to be addressed. Conclusions of the project note that standardizing IPV screening and improved trauma-informed care enhanced early detection while increasing patient safety. This underscores the clinics need for continued IPV training, more IPV related resources, and cultural competence that will sustain positive improvements

Retroactive Definitions: The Problem with the Traditional Marriage Argument

Words often change meaning over time. For example, until the 1960s, the word “gay” meant “Light-hearted and carefree” or “Brightly coloured; showy”.[1] But after the 1960’s, the definition of “gay” drastically changed, to meaning a “homosexual.”[2] “When you\u27re with the Flintstones, Have a yabba dabba-do time A dabba-do time, We\u27ll have a gay old time!”[3] This means that when we look at the theme song for the classic cartoon The Flinstones, we should not apply our definition of what gay means to how it is used in the theme song. Definitions of marriage work much in the same way as any other definition. The definition is reliant on the repeated use of an act or word. Looking over the course of American history, marriage has been in a constant state of change. Marriage was used by immigrant women in Jamestown as a way to gain wealth and social standing. In the 1800s, personal agency entered the practice of marriage and women and men viewed love as the driving force. During the American Civil War, the ties between extensive courtship practices and the involvement of the betrothed’s families in the marriage was lessened. There were many who tried to claim that these changes were tearing down the institution of marriage. We now live in a climate that seems to be speaking with similar rhetoric. Proponents for traditional marriage believe that same-sex marriage goes against something that is fundamental for the practice of proper marriage. Looking at the history of marriage in America, it is hard to conclude that this is widely accepted throughout American history. Marriage holds many economic and societal roles that are not often talked about by proponents of traditional marriage. Marriage has always been defined retroactively by people who are attempting to address changes in how marriage is practiced and the modern argument about traditional marriage is a part of this continued trend. Marriage is defined by how people practice it, not by some arbitrary definition. [1] “Gay - Definition of Gay in English | Oxford Dictionaries.” Oxford Dictionaries | English. Accessed January 24, 2017. https://en.oxforddictionaries.com/definition/gay. [2] Ibid [3] The Flintstones. Animation, Comedy, Family, 1960

Product-free sets in approximate subgroups of distal groups

Recall that a subset $X$ of a group $G$ is 'product-free' if $X^2\cap X=\varnothing$, ie if $xy\notin X$ for all $x,y\in X$. Let $G$ be a group definable in a distal structure. We prove there are constants $c>0$ and $\delta\in(0,1)$ such that every finite subset $X\subseteq G$ distinct from $\{1\}$ contains a product-free subset of size at least $\delta|X|^{c+1}/|X^2|^c$. In particular, every finite $k$-approximate subgroup of $G$ distinct from $\{1\}$ contains a product-free subset of density at least $\delta/k^c$. The proof is short, and follows quickly from Ruzsa calculus and an iterated application of Chernikov and Starchenko's distal regularity lemma.Comment: added some remarks on the case G=GLn(C), an appendix on solvable groups, and some more reference

Torsion-free and distal dp-minimal groups

Let $G$ be a dp-minimal group. We discuss two different hypotheses on $G$; first we show that, if $G$ is torsion-free, then it is abelian. Then we investigate the structure of $G$ when it admits a distal f-generic type, showing in particular that the quotient of $G$ by its FC-center can then be naturally equipped with the structure of a valued group. As an application of this, we show that, in this case, $G$ is virtually nilpotent

The Voluntary Carbon Market: Managing the Private Provision of Public Goods

While much work has examined the large-scale compliance-based carbon offset programs associated with the Kyoto Protocol and Clean Development Mechanism, there has been far less focus on the voluntary purchasing of carbon offsets. This critical literature review will look at the formation and management of the demand for voluntary carbon offsets within the United States. It will frame carbon offsets as impure public goods and review possible explanations as to why private provision has been so active in the U.S. market. The paper will then survey the efficiency gains and other benefits associated with the voluntary market. It will highlight the informational asymmetries that undermine these benefits through moral hazard and adverse selection. To mitigate these concerns, it will examine the current regulatory environment for voluntary offsets and propose possible pathways to optimize the market through regulation in the future