| 1. |
- Logmani-Aßmann, J., et al.
(author)
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Forest Set-Aside Policy for International Biodiversity Targets? : Obstructive Bureaucratic Territoriality in Germany and Sweden
- 2022
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In: International forestry review. - : Commonwealth Forestry Association. - 1465-5489 .- 2053-7778. ; 23:4, s. 448-461
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Journal article (peer-reviewed)abstract
- Under the auspices of the Convention on Biological Diversity, the Aichi Biodiversity Target 11 requires setting aside vast currently managed areas for conservation purposes. Following bureaucratic politics theory, forestry and environmental domestic bureaucracies use these international targets in their struggle for power and territoriality over forested areas. Against this background, this study aims to analyze the resulting politics on setting aside forest areas from active forest management in Germany and Sweden. Employing a qualitative case study design and empirical data from policy documents and key informant interviews, our results indicate that bureaucracies prioritize instruments that are well aligned with their formal objectives, the interests of their informal constituencies, and their territorial interests. Such struggles dominate the development of policy instruments in both countries obstructing political compromise which results in a logjam in the development of substantial forest set-aside policy. We conclude that unless domestic politics and key bureaucracies provide conducive political conditions international commitments will be very difficult to achieve, even if they are formulated into clearly measurable international targets.
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| 2. |
- Blicharska, Malgorzata, 1979-, et al.
(author)
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Between biodiversity conservation and sustainable forest management - A multidisciplinary assessment of the emblematic Bialowieza Forest case
- 2020
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In: Biological Conservation. - : Elsevier BV. - 0006-3207 .- 1873-2917. ; 248
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Journal article (peer-reviewed)abstract
- The tension between biodiversity conservation and multipurpose forest management may lead to conflicts. An internationally prominent example is the Bialowieza Forest Massif (BFM), an extensive forest complex with high levels of naturalness. We apply a systematic, multidisciplinary assessment process to review empirical evidence on different dimensions of the BFM conflict. While there is broad consensus that this forest massif is an exceptional place worth conserving and that a way forward is a zonation system combining conservation with management, exactly how this should be done has yet to be agreed upon. Our assessment shows that the key reasons for the BFM controversy go beyond the availability of knowledge on the ecological status of the BFM and include: 1) evidence stemming from different sources, which is often contradictory and prone to different interpretations; 2) knowledge gaps, particularly with regard to socio-economic drivers and beneficiaries as well as uncertainties about future trends; 3) fundamentally different values and priorities among stakeholder groups, resulting in power struggles, and an overall lack of trust. We conclude that evidence-based knowledge alone is insufficient to cope with complex conservation conflicts. While more evidence may help assess the consequences of decisions, the actual management decisions depend on different actors' worldviews, which are rooted in their professional identities and power, and their political and legal realities. This calls for conflict management through a well-organized participatory process organized and supervised by a body deemed legitimate by the groups involved.
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| 3. |
- Chetelat, G., et al.
(author)
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Amyloid-PET and 18-F-FDG-PET in the diagnostic investigation of Alzheimer's disease and other dementias
- 2020
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In: Lancet Neurology. - 1474-4422 .- 1474-4465. ; 19:11, s. 951-962
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Research review (peer-reviewed)abstract
- Various biomarkers are available to support the diagnosis of neurodegenerative diseases in clinical and research settings. Among the molecular imaging biomarkers, amyloid-PET, which assesses brain amyloid deposition, and F-18-fluorodeoxyglucose (F-18-FDG) PET, which assesses glucose metabolism, provide valuable and complementary information. However, uncertainty remains regarding the optimal timepoint, combination, and an order in which these PET biomarkers should be used in diagnostic evaluations because conclusive evidence is missing. Following an expert panel discussion, we reached an agreement on the specific use of the individual biomarkers, based on available evidence and clinical expertise. We propose a diagnostic algorithm with optimal timepoints for these PET biomarkers, also taking into account evidence from other biomarkers, for early and differential diagnosis of neurodegenerative diseases that can lead to dementia. We propose three main diagnostic pathways with distinct biomarker sequences, in which amyloid-PET and F-18-FDG-PET are placed at different positions in the order of diagnostic evaluations, depending on clinical presentation. We hope that this algorithm can support diagnostic decision making in specialist clinical settings with access to these biomarkers and might stimulate further research towards optimal diagnostic strategies.
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| 4. |
- Collij, Lyduine E., et al.
(author)
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Clinical outcomes up to 9 years after [18F]flutemetamol amyloid-PET in a symptomatic memory clinic population
- 2023
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In: Alzheimer's Research and Therapy. - 1758-9193. ; 15:1
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Journal article (peer-reviewed)abstract
- Background: Previous studies demonstrated increases in diagnostic confidence and change in patient management after amyloid-PET. However, studies investigating longitudinal outcomes over an extended period of time are limited. Therefore, we aimed to investigate clinical outcomes up to 9 years after amyloid-PET to support the clinical validity of the imaging technique. Methods: We analyzed longitudinal data from 200 patients (M age = 61.8, 45.5% female, M MMSE = 23.3) suspected of early-onset dementia that underwent [18F]flutemetamol-PET. Baseline amyloid status was determined through visual read (VR). Information on mortality was available with a mean follow-up of 6.7 years (range = 1.1–9.3). In a subset of 108 patients, longitudinal cognitive scores and clinical etiological diagnosis (eDx) at least 1 year after amyloid-PET acquisition were available (M = 3.06 years, range = 1.00–7.02). VR − and VR + patients were compared on mortality rates with Cox Hazard’s model, prevalence of stable eDx using chi-square test, and longitudinal cognition with linear mixed models. Neuropathological data was available for 4 patients (mean delay = 3.59 ± 1.82 years, range = 1.2–6.3). Results: At baseline, 184 (92.0%) patients were considered to have dementia. The majority of VR + patients had a primary etiological diagnosis of AD (122/128, 95.3%), while the VR − group consisted mostly of non-AD etiologies, most commonly frontotemporal lobar degeneration (30/72, 40.2%). Overall mortality rate was 48.5% and did not differ between VR − and VR + patients. eDx at follow-up was consistent with baseline diagnosis for 92/108 (85.2%) patients, with most changes observed in VR − cases (VR − = 14/35, 40% vs VR + = 2/73, 2.7%, χ 2 = 26.03, p < 0.001), who at no time received an AD diagnosis. VR + patients declined faster than VR − patients based on MMSE (β = − 1.17, p = 0.004), episodic memory (β = − 0.78, p = 0.003), fluency (β = − 1.44, p < 0.001), and attention scores (β = 16.76, p = 0.03). Amyloid-PET assessment was in line with post-mortem confirmation in all cases; two cases were VR + and showed widespread AD pathology, while the other two cases were VR − and showed limited amyloid pathology. Conclusion: In a symptomatic population, we observed that amyloid-status did not impact mortality rates, but is predictive of cognitive functioning over time across several domains. Also, we show particular validity for a negative amyloid-PET assessment, as these patients did not receive an AD diagnosis at follow-up.
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| 5. |
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| 6. |
- Mathies, Franziska L., et al.
(author)
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The Early Perfusion Image Is Useful to Support the Visual Interpretation of Brain Amyloid-PET With 18F-Flutemetamol in Borderline Cases
- 2024
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In: CLINICAL NUCLEAR MEDICINE. - 0363-9762 .- 1536-0229. ; 49:9, s. 838-846
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Journal article (peer-reviewed)abstract
- Purpose: Visual interpretation of brain amyloid-beta (A beta) PET can be difficult in individuals with borderline A beta burden. Coregistration with individual MRI is recommended in these cases, which, however, is not always available. This study evaluated coregistration with the early perfusion frames acquired immediately after tracer injection to support the visual interpretation of the late A beta-frames in PET with F-18-flutemetamol (FMM). Patients and Methods: Fifty dual-time-window FMM-PET scans of cognitively normal subjects with 0 to 60 Centiloids were included retrospectively (70.1 +/- 6.9 years, 56% female, MMSE score 28.9 +/- 1.3, 42% APOE epsilon 4 carrier). Regional A beta load was scored with respect to a 6-point Likert scale by 3 independent raters in the 10 regions of interest recommended for FMM reading using 3 different settings: A beta image only, A beta image coregistered with MRI, and A beta image coregistered with the perfusion image. The impact of setting, within- and between-readers variability, region of interest, and A beta-status was tested by repeated-measure analysis of variance of the Likert score. Results: The Centiloid scale ranged between 2 and 52 (interquartile range, 7-19). Support of visual scoring by the perfusion image resulted in the best discrimination between A beta-positive and A beta-negative cases, mainly by improved certainty of excluding A beta plaques in A beta-negative cases (P = 0.030). It also resulted in significantly higher between-rater agreement. The setting effect was most pronounced in the frontal lobe and in the posterior cingulate cortex/precuneus area (P = 0.005). Conclusions: The early perfusion image is a suitable alternative to T1-weighted MRI to support the visual interpretation of the late A beta image in FMM-PET.
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| 9. |
- van den Berg, Rosanne L., et al.
(author)
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Digital remote assessment of speech acoustics in cognitively unimpaired adults : feasibility, reliability and associations with amyloid pathology
- 2024
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In: Alzheimer's Research and Therapy. - 1758-9193. ; 16:1
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Journal article (peer-reviewed)abstract
- Background: Digital speech assessment has potential relevance in the earliest, preclinical stages of Alzheimer’s disease (AD). We evaluated the feasibility, test-retest reliability, and association with AD-related amyloid-beta (Aβ) pathology of speech acoustics measured over multiple assessments in a remote setting. Methods: Fifty cognitively unimpaired adults (Age 68 ± 6.2 years, 58% female, 46% Aβ-positive) completed remote, tablet-based speech assessments (i.e., picture description, journal-prompt storytelling, verbal fluency tasks) for five days. The testing paradigm was repeated after 2–3 weeks. Acoustic speech features were automatically extracted from the voice recordings, and mean scores were calculated over the 5-day period. We assessed feasibility by adherence rates and usability ratings on the System Usability Scale (SUS) questionnaire. Test-retest reliability was examined with intraclass correlation coefficients (ICCs). We investigated the associations between acoustic features and Aβ-pathology, using linear regression models, adjusted for age, sex and education. Results: The speech assessment was feasible, indicated by 91.6% adherence and usability scores of 86.0 ± 9.9. High reliability (ICC ≥ 0.75) was found across averaged speech samples. Aβ-positive individuals displayed a higher pause-to-word ratio in picture description (B = -0.05, p = 0.040) and journal-prompt storytelling (B = -0.07, p = 0.032) than Aβ-negative individuals, although this effect lost significance after correction for multiple testing. Conclusion: Our findings support the feasibility and reliability of multi-day remote assessment of speech acoustics in cognitively unimpaired individuals with and without Aβ-pathology, which lays the foundation for the use of speech biomarkers in the context of early AD.
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