A method to combine cognitive and neurophysiological assessments of the elderly

BACKGROUND

The development of better treatments for brain diseases of the elderly will necessitate more sensitive and efficient means of repeatedly assessing an individual's neurocognitive status.

AIM

To illustrate the development of an assessment combining episodic memory and working memory tasks with simultaneous electroencephalography and evoked potential (EP) brain function measures.

METHODS

Data from matched groups of elderly subjects with mildly impaired episodic verbal memory on neuropsychological tests and those with no objective signs of impairment were used for scale development. An exploratory multivariate divergence analysis selected task performance and neurophysiological variables that best recognized impairment. Discriminant validity was then initially assessed on separate impaired and unimpaired groups.

RESULTS

Decreased response accuracy and parietal late positive component EP amplitude in the episodic memory task best characterized impaired subjects. Sensitivity in recognizing impairment in the validation analysis was 89% with 79% specificity (area under the curve = 0.94). Retest reliability was 0.89 for the unimpaired and 0.74 for the impaired validation groups.

CONCLUSION

These promising initial results suggest that with further refinement and testing, an assessment combining cognitive task performance with simultaneous neurofunctional measures could eventually provide an important benefit for clinicians and researchers.

Bioactive glass scaffolds for bone regeneration and their hierarchical characterisation

Scaffolds are needed that can act as temporary templates for bone regeneration and actively stimulate vascularized bone growth so that bone grafting is no longer necessary. To achieve this, the scaffold must have a suitable interconnected pore network and be made of an osteogenic material. Bioactive glass is an ideal material because it rapidly bonds to bone and degrades over time, releasing soluble silica and calcium ions that are thought to stimulate osteoprogenitor cells. Melt-derived bioactive glasses, such as the original Bioglass® composition, are available commercially, but porous scaffolds have been difficult to produce because Bioglass and similar compositions crystallize on sintering. Sol-gel foam scaffolds have been developed that avoid this problem. They have a hierarchical pore structure comprising interconnected macropores, with interconnect diameters in excess of the 100 μm that is thought to be needed for vascularized bone ingrowth, and an inherent nanoporosity of interconnected mesopores (2–50 nm) which is beneficial for the attachment of osteoprogenitor cells. They also have a compressive strength in the range of cancellous bone. This paper describes the optimized sol-gel foaming process and illustrates the importance of optimizing the hierarchical structure from the atomic through nano, to the macro scale with respect to biological response.

Interleukin-17-producing T-helper cells and related cytokines in human airways exposed to endotoxin

Previous studies on mouse models have indicated that interleukin (IL)-17 and IL-17-producing T-helper (Th) cells are important for pulmonary host defence against Gram-negative bacteria. Human correlates to these findings have not yet been demonstrated. The aim of the present study was to determine whether or not IL-17-producing Th cells are present and whether IL-17 and other Th17-associated cytokines are involved in the immunological response to endotoxin in human airways. Segmental exposure to endotoxin and contralateral exposure to vehicle were performed in the lungs of healthy volunteers, with subsequent bronchoalveolar lavage 12 or 24 h after exposure to study local changes in cytokines and inflammatory cells. Endotoxin exposure increased concentrations of IL-17, IL-22 and their downstream effector molecules, human β-defensin-2 and IL-8/CXC chemokine ligand 8, in bronchoalveolar lavage fluid. Th cells with the capacity to produce IL-17 were found among the bronchoalveolar lavage cells, and expression of IL-17 mRNA correlated with expression of the transcription factor, retinoic-acid-receptor-related orphan receptor C variant 2. Moreover, endotoxin increased the numbers of neutrophils, macrophages and IL-17-producing T-cells, as well as the concentration of the Th17-regulating cytokines, IL-21 and IL-23. In conclusion, IL-17-producing Th cells are present, and IL-17, as well as other Th17-associated cytokines, is involved in the immunological response to endotoxin in human airways.

Recent technique developments and applications of solid state NMR in characterising inorganic materials

A broad overview is given of some key recent developments in solid state NMR techniques that have driven enhanced applications to inorganic materials science. Reference is made to advances in hardware, pulse sequences and associated computational methods (e.g. first principles calculations, spectral simulation), along with their combination to provide more information about solid phases. The resulting methodology has allowed more nuclei to be observed and more structural information to be extracted. Cross referencing between experimental parameters and their calculation from the structure has given an added dimension to NMR as a characterisation probe of materials. Emphasis is placed on the progress made in the last decade especially from those nuclei that were little studied previously. The general points about technique development and the increased range of nuclei observed are illustrated through some specific exemplars from inorganic materials science.

Thermometers for low temperature Magic Angle Spinning NMR

The measurement of temperature in a Magic Angle Spinning NMR probe in the temperature range 85-300K is discussed. It is shown that the shift of the (119)Sn resonance of Sm(2)Sn(2)O(7) makes a good thermometer with shift being given by delta=223 - 9.54x10(4)/Tppm and a potential precision of better than 0.5K over the entire temperature range. The sensitivity is such (e.g. 4.2ppm/K at 150K) that small temperature gradients across the sample can readily be measured. Furthermore, since the spin-lattice relaxation time is very short, measurements can be made in approximately 1s enabling relatively rapid temperature changes to be followed. Values for the chemical shift of (207)Pb in Pb(NO(3))(2) down to approximately 85K are also presented. Although the (207)Pb shift variation is approximately linear near room temperature (we find a slope 0.725+/-0.002ppm/K over the range 293-153K), it clearly deviates from linearity below approximately 130K.

Public and biobank participant attitudes toward genetic research participation and data sharing

Research assessing attitudes toward consent processes for high-throughput genomic-wide technologies and widespread sharing of data is limited. In order to develop a better understanding of stakeholder views toward these issues, this cross-sectional study assessed public and biorepository participant attitudes toward research participation and sharing of genetic research data. Forty-nine individuals participated in 6 focus groups; 28 in 3 public focus groups and 21 in 3 NUgene biorepository participant focus groups. In the public focus groups, 75% of participants were women, 75% had some college education or more, 46% were African-American and 29% were Hispanic. In the NUgene focus groups, 67% of participants were women, 95% had some college education or more, and the majority (76%) of participants was Caucasian. Five major themes were identified in the focus group data: (a) a wide spectrum of understanding of genetic research; (b) pros and cons of participation in genetic research; (c) influence of credibility and trust of the research institution; (d) concerns about sharing genetic research data and need for transparency in the Policy for Sharing of Data in National Institutes of Health-Supported or Conducted Genome-Wide Association Studies; (e) a need for more information and education about genetic research. In order to increase public understanding and address potential concerns about genetic research, future efforts should be aimed at involving the public in genetic research policy development and in identifying or developing appropriate educational strategies to meet the public's needs.

QuadFit--a new cross-platform computer program for simulation of NMR line shapes from solids with distributions of interaction parameters

A new Java computer program called QuadFit has been written to simulate NMR line shapes from solid materials. The program takes into account the major interactions, with a key feature that distributions of isotropic chemical shift and quadrupolar interaction parameters can be calculated, which are often encountered in amorphous and disordered materials. The quadrupolar interaction can be simulated for all the transitions for both half-integer and integer spins. The utility of the program is demonstrated with examples of (27)Al (nuclear spin I=5/2) in an atomically disordered aluminoborate mullite, (65)Cu (I=3/2) in CuInSe(2) and (10)B (I=3) in amorphous B(2)O(3). The program has good cross-platform compatibility and is written for high stability. The program has been designed with an easy to use graphical interface. It can be run efficiently on any reasonably powerful PC and is freely available from the Warwick website (http://go.warwick.ac.uk/quadfit).

Structural characterization by x-ray methods of novel antimicrobial gallium-doped phosphate-based glasses

Antimicrobial gallium-doped phosphate-based glasses of general composition (P(2)O(5))(0.45)(CaO)(0.16)(Na(2)O)(0.39-x)(Ga(2)O(3))(x) (where x=0, 0.01, 0.03, and 0.05) have been studied using the advanced synchrotron-based techniques of Ga K-edge x-ray absorption spectroscopy and high-energy x-ray diffraction to provide a structural insight into their unique properties. The results show that the Ga(3+) ions are octahedrally coordinated. Furthermore, substitution of Na(2)O by Ga(2)O(3) strengthens the phosphate network structure because the presence of GaO(6) octahedra inhibits the migration of the remaining Na(+) ions. The results are discussed in terms of the use of Na(2)O-CaO-P(2)O(5) glasses as controlled-delivery devices for antimicrobial Ga(3+) ions in biomedical applications. We are thereby able to relate the atomic-scale environment of the Ga(3+) ions beneficially to the glass dissolution, and thus to their ability to disrupt bacterial cell activity by usurping the role of iron.

A (59)Co NMR study to observe the effects of ball milling on small ferromagnetic cobalt particles

To demonstrate the potential of nuclear magnetic resonance (NMR) spectroscopy for investigating detailed structural properties in ferromagnetic materials, three different particle sized cobalt (Co) powders have been ball milled for 24h are accurately characterised by internal-field (59)Co NMR. The (59)Co NMR spectra show distinct resonance bands corresponding to the different Co sites, face-centred-cubic (fcc), hexagonal-close-packed (hcp) and stacking faults (sfs), in Co metal powders. The hcp+fcc-->hcp phase transition encouraged by ball-milling was observed and quantitative values for each Co environment were obtained.

Cell proliferation follows acoustically-induced hair cell bundle loss in the zebrafish saccule

Fishes are capable of regenerating sensory hair cells in the inner ear after acoustic trauma. However, a time course of auditory hair cell regeneration has not been established for zebrafish. Adult zebrafish (Danio rerio) were exposed to a 100 Hz pure tone at 179 dB re 1 microPa RMS for 36 h and then allowed to recover for 0-14 days before morphological analysis. Hair cell bundle loss and recovery were determined using phalloidin to visualize hair bundles. Cell proliferation was quantified through bromodeoxyuridine (BrdU) labeling. Immediately following sound exposure, zebrafish saccules exhibited significant hair bundle damage (e.g., splayed, broken, and missing stereocilia) and loss (i.e., missing bundles and lesions in the epithelia) in the caudal region. Hair bundle counts increased over the course of the experiment, reaching pre-treatment levels at 14 days post-sound exposure (dpse). Low levels of proliferation were observed in untreated controls, indicating that some cells of the zebrafish saccule are mitotically active in the absence of a damaging event. In sound-exposed fish, cell proliferation peaked two dpse in the caudal region, and to a lesser extent in the rostral region. This proliferation was followed by an increase in numbers of cuticular plates with rudimentary stereocilia and immature-like hair bundles at 7 and 14 dpse, suggesting that at least some of the saccular cell proliferation resulted in newly formed hair cells. This study establishes a time course of hair cell bundle regeneration in the zebrafish inner ear and demonstrates that cell proliferation is associated with the regenerative process.

Fully-automated quantification of regional brain volumes for improved detection of focal atrophy in Alzheimer disease

Volumetric analysis of structural MR images of the brain may provide quantitative evidence of neurodegeneration and help identify patients at risk for rapid clinical deterioration. This note describes tests of a fully automated MR imaging postprocessing system for volumetric analysis of structures (such as the hippocampus) known to be affected in early Alzheimer disease (AD). The system yielded results that correlated highly with independent computer-aided manual segmentation and were sensitive to the anatomic atrophy characteristic of mild AD.

A natural abundance (77)Se solid-state NMR study of inorganic compounds

Various inorganic selenium-based compounds were analysed by (77)Se solid-state NMR, and a distinct difference in chemical shift ranges for compounds where selenium is present as selenide (Se(2-)) ionically and covalently bonded systems was observed. The selenides exhibit a shift range of approximately -700 to -100ppm, as opposed to 700 to 1600ppm for the compounds where there tends to be more direct covalent bonding to the selenium. The anisotropic hyperfine shift observed in NbSe(2) is shown to be axially symmetric, where the H(11) component is found to be normal to the Se3-trigonal plane.

Pharmacokinetics of new 625 mg nelfinavir formulation during pregnancy and postpartum

OBJECTIVES

Our objective was to evaluate the pharmacokinetics of nelfinavir (NFV) (625 mg tablets) 1250 mg twice daily during pregnancy and postpartum.

METHODS

The participants were HIV-1-infected pregnant women enrolled in P1026s and receiving NFV (625 mg tablets) 1250 mg twice daily as part of routine clinical care. Intensive steady-state 12-h NFV pharmacokinetic profiles were performed during pregnancy and postpartum. The target NFV area under the plasma concentration-time curve (AUC(0-12)) was >or=10th percentile NFV AUC(0-12) in non-pregnant historical controls (18.5 microg h/mL).

RESULTS

Of 27 patients receiving NFV, pharmacokinetic data were available for four (second trimester), 27 (third trimester) and 22 (postpartum) patients. The NFV maximum concentration (C(max)), 12-h post-dose concentration (C(12)) and AUC(0-12) were significantly lower during the third trimester compared to postpartum (P<or=0.03). The metabolite hydroxyl-tert-butylamide (M8) AUC(0-12) and the M8/NFV AUC ratio were lower during the third trimester compared to postpartum (P<0.01). The NFV AUC(0-12) exceeded the AUC(0-12) target for 15/27 (56%) and 21/22 (95%) of third trimester and postpartum patients, respectively. The minimum concentration (C(min)) was above the suggested minimum trough concentration (0.8 mug/mL) in 15% (third trimester) and 18% (postpartum). The plasma viral load was <400 HIV-1 RNA copies/mL in 81% of patients at delivery.

CONCLUSIONS

These results suggest that higher doses of NFV should be considered during pregnancy.

Multigene analysis suggests ecological speciation in the fungal pathogen Claviceps purpurea

Claviceps purpurea is an important pathogen of grasses and source of novel chemical compounds. Three groups within this species (G1, G2 and G3) have been recognized based on habitat association, sclerotia and conidia morphology, as well as alkaloid production. These groups have further been supported by Random Amplification of Polymorphic DNA (RAPD) and amplified fragment length polymorphism (AFLP) markers, suggesting this species may be more accurately described as a species complex. However, all divergent ecotypes can coexist in sympatric populations with no obvious physical barriers to prevent gene flow. In this study, we used both phylogenetic and population genetic analyses to test for speciation within C. purpurea using DNA sequences from ITS, a RAS-like locus, and a portion of beta-tubulin. The G1 types are significantly divergent from the G2/G3 types based on each of the three loci and the combined dataset, whereas the G2/G3 types are more integrated with one another. Although the G2 and G3 lineages have not diverged as much as the G1 lineage based on DNA sequence data, the use of three DNA loci does reliably separate the G2 and G3 lineages. However, the population genetic analyses strongly suggest little to no gene flow occurring between the different ecotypes, and we argue that this process is driven by adaptations to ecological habitats; G1 isolates are associated with terrestrial grasses, G2 isolates are found in wet and shady environments, and G3 isolates are found in salt marsh habitats.

Neuropsychological and neurophysiologic effects of carbamazepine and levetiracetam

BACKGROUND

The relative effects of levetiracetam (LEV) and carbamazepine (CBZ) on cognitive and neurophysiologic measures are uncertain.

METHODS

The effects of LEV and CBZ were compared in healthy adults using a randomized, double-blind, two-period crossover design. Outcome measures included 11 standard neuropsychological tests and the score from a cognitive-neurophysiologic test of attention and memory. Evaluations were conducted at screening, baseline pre-drug treatment, end of each maintenance phase (4 weeks), and end of each washout period after drug treatment.

RESULTS

A total of 28 adults (17 women) with mean age of 33 years (range 18 to 51) completed the study. Mean maintenance doses (+/-SD) were CBZ = 564 mg/day (110) and LEV = 2,000 mg/day (0). CBZ was adjusted to mid-range therapeutic level. Mean serum levels (+/-SD) were CBZ = 7.5 mcg/mL (1.5) and LEV = 32.2 mcg/mL (11.2). An overall composite score including all measures revealed worse effects for CBZ compared to LEV (p <or= 0.001) in the primary analysis and for CBZ (p <or= 0.001) and LEV (p <or= 0.05) compared to non-drug in secondary analyses. Across the 34 individual variables, CBZ was worse than LEV on 44% (15/34); none favored CBZ. Compared to the non-drug average, CBZ was worse for 76% (26/34), and LEV was worse for 12% (4 of 34). Sensitivity and specificity of standard neuropsychological tests and the cognitive-neurophysiologic test were determined to direct future studies; detection was most accurate by the cognitive-neurophysiologic test.

CONCLUSIONS

Levetiracetam produces fewer untoward neuropsychological and neurophysiologic effects than carbamazepine in monotherapy at the dosages and timeframes employed in this study.

In situ high-energy X-ray diffraction study of a bioactive calcium silicate foam immersed in simulated body fluid

The method of in situ time-resolved high-energy X-ray diffraction, using the intrinsically highly collimated X-ray beam generated by the European Synchrotron Radiation Facility, is demonstrated. A specially designed cell, which allows the addition of liquid components, has been used to study the reaction mechanisms of a foamed bioactive calcia-silica sol-gel glass immersed in simulated body fluid. Analysis of the X-ray diffraction data from this experiment provides atomic distances, via the pair correlation functions, at different stages of the dissolution of the glass and of the associated calcium phosphate, and ultimately hydroxyapatite, i.e. bone mineral, formation. Hence, changes in the atomic scale structure can be analysed as a function of reaction time, giving an insight into the evolution of the structure of both the glass matrix and the hydroxyapatite surface growth.

The effect of oxide additions on medium-range order structures in borosilicate glasses

Boron-11 nuclear magnetic resonance (MAS NMR) and Raman spectroscopies have been used to study four families of glasses: xCs₂O(100-x)ZMW (0<x<10), where ZMW represents the borosilicate glass MW to which oxides Z (Al₂O₃, La₂O₃ and MgO) are added such that, overall, 1.0≤R (= [modifier]/[B₂O₃])≤2.5; K (= [SiO₂]/[B₂O₃]) = 3.2. These glasses are related to the system used for the vitrification of high-level nuclear waste. The spectra reveal the presence of reedmergnerite and danburite medium-range order structural units in the glasses. The fraction of danburite units increases with the addition of caesium oxide when Al₂O₃ or La₂O₃ are present, and decreases when MgO is present.

The structure of phosphate glass biomaterials from neutron diffraction and 31P nuclear magnetic resonance data

Neutron diffraction and ³¹P nuclear magnetic resonance spectroscopy were used to probe the structure of phosphate glass biomaterials of general composition (CaO)_0.5-x(Na₂O)_x(P₂O₅)_0.5 (x = 0, 0.1 and 0.5). The results suggest that all three glasses have structures based on chains of Q² phosphate groups. Clear structural differences are observed between the glasses containing Na₂O and CaO. The P-O bonds to bridging and non-bridging oxygens are less well resolved in the neutron data from the samples containing CaO, suggesting a change in the nature of the bonding as the field strength of the cation increases [Formula: see text]. In the (CaO)_0.5(P₂O₅)_0.5 glass most of the Ca²⁺ ions are present in isolated CaO_x polyhedra whereas in the (Na₂O)_0.5(P₂O₅)_0.5 glass the NaO_x polyhedra share edges leading to a Na-Na correlation. The results of the structural study are related to the properties of the (CaO)_0.4(Na₂O)_0.1(P₂O₅)_0.5 biomaterial.

Determination of NMR interaction parameters from double rotation NMR

It is shown that the anisotropic NMR parameters for half-integer quadrupolar nuclei can be determined using double rotation (DOR) NMR at a single magnetic field with comparable accuracy to multi-field static and MAS experiments. The (17)O nuclei in isotopically enriched l-alanine and OPPh(3) are used as illustrations. The anisotropic NMR parameters are obtained from spectral simulation of the DOR spinning sideband intensities using a computer program written with the GAMMA spin-simulation libraries. Contributions due to the quadrupolar interaction, chemical shift anisotropy, dipolar coupling and J coupling are included in the simulations. In l-alanine the oxygen chemical shift span is 455 +/- 20 ppm and 350 +/- 20 ppm for the O1 and O2 sites, respectively, and the Euler angles are determined to an accuracy of +/- 5-10 degrees . For cases where effects due to heteronuclear J and dipolar coupling are observed, it is possible to determine the angle between the internuclear vector and the principal axis of the electric field gradient (EFG). Thus, the orientation of the major components of both the EFG and chemical shift tensors (i.e., V(33) and delta(33)) in the molecular frame may be obtained from the relative intensity of the split DOR peaks. For OPPh(3) the principal axis of the (17)O EFG is found to be close to the O-P bond, and the (17)O-(31)P one-bond J coupling ((1)J(OP)=161 +/- 2 Hz) is determined to a much higher accuracy than previously.