Electrical impedance myography as a biomarker to assess ALS progression

Abstract Electrical impedance myography (EIM), a non-invasive, electrophysiological technique, has preliminarily shown value as an ALS biomarker. Here we perform a multicenter study to further assess EIM's potential for tracking ALS. ALS patients were enrolled across eight sites. Each subject underwent EIM, handheld dynamometry (HHD), and the ALS Functional Rating Scale-revised (ALSFRS-R) regularly. Techniques were compared by assessing the coefficient of variation (CoV) in the rate of decline and each technique's correlation to survival. Results showed that in the 60 patients followed for one year, EIM phase measured from the most rapidly progressing muscle in each patient had a CoV in the rate of decline of 0.62, compared to HHD (0.82) and the ALSFRS-R (0.74). Restricting the measurements to the first six months gave a CoV of 0.55 for EIM, 0.93 for HHD, and 0.84 for ALSFRS-R. For both time-periods, all three measures correlated with survival. Based on these data, a six-month clinical trial designed to detect a 20% treatment effect with 80% power using EIM would require only 95 patients/arm compared to the ALSFRS-R, which would require 220 subjects/arm. In conclusion, EIM can serve as a useful ALS biomarker that offers the prospect of greatly accelerating phase 2 clinical trials.     

Enhanced In Vitro Formation and Antibiotic Resistance of Nonattached Pseudomonas aeruginosa Aggregates through Incorporation of Neutrophil Products

Pseudomonas aeruginosa is a major pathogen in cystic fibrosis (CF) lung disease. Children with CF are routinely exposed to P. aeruginosa from the natural environment, and by adulthood, 80% of patients are chronically infected. P. aeruginosa in the CF airway exhibits a unique biofilm-like structure, where it grows in small clusters or aggregates of bacteria in association with abundant polymers of neutrophil-derived components F-actin and DNA, among other components. These aggregates differ substantially in size and appearance compared to surface-attached in vitro biofilm models classically utilized for studies but are believed to share properties of surface-attached biofilms, including antibiotic resistance. However, little is known about the formation and function of surface-independent modes of biofilm growth, how they might be eradicated, and quorum sensing communication. To address these issues, we developed a novel in vitro model of P. aeruginosa aggregates incorporating human neutrophil-derived products. Aggregates grown in vitro and those found in CF patients'' sputum samples were morphologically similar; viable bacteria were distributed in small pockets throughout the aggregate. The lasA quorum sensing gene was differentially expressed in the presence of neutrophil products. Importantly, aggregates formed in the presence of neutrophils acquired resistance to tobramycin, which was lost when the aggregates were dispersed with DNase, and antagonism of tobramycin and azithromycin was observed. This novel yet simple in vitro system advances our ability to model infection of the CF airway and will be an important tool to study virulence and test alternative eradication strategies against P. aeruginosa.     

Stigma in the media: Investigating journalism students attitudes towards mental illness

Given the profound role that media play in public opinion, there exists an ongoing necessity to understand the portrayal of mental illness by journalists. There is a plethora of studies that have examined how mental illness is portrayed in the media, but few studies have sought to understand what journalist opinions about mental illness are, and none could be found regarding journalism students’ opinions. This study aimed to bridge this gap by examining journalism student’s attitudes towards mental illness using the Social Distance Scale (SDS). This study adheres to STROBE guidelines for cross-sectional studies. One hundred and seventy-two undergraduate journalism students (n = 172) completed the SDS with findings suggesting that students had moderate stigmatizing attitudes, with varying degrees of stigma present depending on the social context. Positively framed reporting and constructive media coverage surrounding mental illness may be improved by shared communication and education with health professionals who specialize in mental health: mental health nurses.     

Secondary amyloidosis in a needle phobic intra-venous drug user

A case of acute-on-chronic renal failure is presented that is the sequela of secondary (AA) amyloidosis in a hepatitis positive intravenous drug user (IVDU) with chronic venous ulceration. The importance of groin examination is stressed when upper limb veins in a suspected IVDU are normal. Recent epidemiological data is discussed that suggests geographical location and the subcutaneous (SC) route of drug administration are both contributing factors to the development of AA amyloidosis and not chronic infection with HIV, HBV or HCV.     

Corroboration of the utility of the Satz-Mogel abbreviated WAIS with hospitalized geriatric patients

The equivalency of standard and Satz-Mogel WAIS scales for psychiatrically hospitalized geriatric patients was explored further in a followup study using a repeated measures design. The two WAIS forms were found to be closely equivalent in test-retest reliability and to have highly similar means and standard deviations. Strong support was given to the authors' previous conclusion that the Satz-Mogel short form of the WAIS may be used interchangeably with the standard WAIS in the clinical assessment of geriatric subjects hospitalized in public psychiatric institutions.     

Dementia Caregivers' Most Pressing Concerns

This primary-care-based study was designed to determine needs as identified by the informal caregiver. A total of 165 caregivers identified selected topics of concern. Depressed caregivers requested more information about depression, adult day care, grief, caregiver feelings, and relaxation. Caregivers of individuals with mild dementia requested more information on confusion, driving, patient depression, shadowing, telling the patient and others, grief, and depression. Behavioral (activities, combativeness, communication, confusion) and stress (healthy lifestyle, grief, relaxation, depression) needs were similar across race, gender, and relationship. However, the clinical characteristics of caregivers (depression) and care recipients (cognitive impairment severity) affected behavioral and stress and coping needs.     

Weed control among planted and direct-seeded Eucalyptus,Acacia and Casuarina with the herbicides diphenamid,oryzalin, clopyralid and fluazifop-butyl

In a glasshouse pot trial, applications of the pre-emergence herbicide oryzalin at rates equivalent to 4 and 8 kg a.i. ha^?1 were toxic to germinating seeds of Eucalyptus maculata, Casuarina glauca and Acacia saligna. The pre-emergence herbicide diphenamid was toxic at rates of 7 and 14 kg a.i. ha^?1 to germinating C. glauca and A. saligna, but not to E. maculata.

Both oryzalin and diphenamid were selective at these rates when applied over newly-planted seedlings of Eucalyptus melliodora, Casuarina cunninghamiana and Acacia baileyana on a former pasture site. Diphenamid gave greater pre-emergence control of grass weeds, while oryzalin was more effective against the broad-leaved weeds. Overall, the most satisfactory long-term weed control and tree response was achieved with oryzalin.

The post-emergence herbicides fluazifop-butyl at 0.6 and 1.2 kg a.e. ha^?1 and clopyralid at 0.25 and 0.5 kg a.e. ha^?1, were mostly selective to the planted seedlings on the former pasture site, but they gave unsatisfactory weed control, probably because of a combination of poor timing of application and a herbicide-tolerant weed flora.