Latent profile analysis in frontotemporal lobar degeneration and related disorders: clinical presentation and SPECT functional correlates

<p>Abstract</p> <p>Background</p> <p>Frontotemporal Lobar Degeneration (FTLD) thus recently renamed, refers to a spectrum of heterogeneous conditions. This same heterogeneity of presentation represents the major methodological limit for the correct evaluation of clinical designation and brain functional correlates. At present, no study has investigated clinical clusters due to specific cognitive and behavioural disturbances beyond current clinical criteria.</p> <p>The aim of this study was to identify clinical FTLD presentation, based on cognitive and behavioural profile, and to define their SPECT functional correlations.</p> <p>Methods</p> <p>Ninety-seven FTLD patients entered the study. A clinical evaluation and standardised assessment were preformed, as well as a brain SPECT perfusion imaging study. Latent Profile Analysis on clinical, neuropsychological, and behavioural data was performed. Voxel-basis analysis of SPECT data was computed.</p> <p>Results</p> <p>Three specific clusters were identified and named "pseudomanic behaviour" (LC1), "cognitive" (LC2), and "pseudodepressed behaviour" (LC3) endophenotypes. These endophenotypes showed a comparable hypoperfusion in left temporal lobe, but a specific pattern involving: medial and orbitobasal frontal cortex in LC1, subcortical brain region in LC2, and right dorsolateral frontal cortex and insula in LC3.</p> <p>Conclusion</p> <p>These findings provide evidence that specific functional-cluster symptom relationship can be delineated in FTLD patients by a standardised assessment. The understanding of the different functional correlates of clinical presentations will hopefully lead to the possibility of individuating diagnostic and treatment algorithms.</p

Human Monoclonal Antibody HCV1 Effectively Prevents and Treats HCV Infection in Chimpanzees

Hepatitis C virus (HCV) infection is a leading cause of liver transplantation and there is an urgent need to develop therapies to reduce rates of HCV infection of transplanted livers. Approved therapeutics for HCV are poorly tolerated and are of limited efficacy in this patient population. Human monoclonal antibody HCV1 recognizes a highly-conserved linear epitope of the HCV E2 envelope glycoprotein (amino acids 412-423) and neutralizes a broad range of HCV genotypes. In a chimpanzee model, a single dose of 250 mg/kg HCV1 delivered 30 minutes prior to infusion with genotype 1a H77 HCV provided complete protection from HCV infection, whereas a dose of 50 mg/kg HCV1 did not protect. In addition, an acutely-infected chimpanzee given 250 mg/kg HCV1 42 days following exposure to virus had a rapid reduction in viral load to below the limit of detection before rebounding 14 days later. The emergent virus displayed an E2 mutation (N415K/D) conferring resistance to HCV1 neutralization. Finally, three chronically HCV-infected chimpanzees were treated with a single dose of 40 mg/kg HCV1 and viral load was reduced to below the limit of detection for 21 days in one chimpanzee with rebounding virus displaying a resistance mutation (N417S). The other two chimpanzees had 0.5-1.0 log(10) reductions in viral load without evidence of viral resistance to HCV1. In vitro testing using HCV pseudovirus (HCVpp) demonstrated that the sera from the poorly-responding chimpanzees inhibited the ability of HCV1 to neutralize HCVpp. Measurement of antibody responses in the chronically-infected chimpanzees implicated endogenous antibody to E2 and interference with HCV1 neutralization although other factors may also be responsible. These data suggest that human monoclonal antibody HCV1 may be an effective therapeutic for the prevention of graft infection in HCV-infected patients undergoing liver transplantation

Functional correlates of Apolipoprotein E genotype in Frontotemporal Lobar Degeneration

BACKGROUND: It has been recently demonstrated that in Frontotemporal Lobar Degeneration (FTLD) memory deficits at presentation are commoner than previously thought. Apolipoprotein E (ApoE) genotype, the major genetic risk factor in sporadic late-onset Alzheimer Disease (AD), modulates cerebral perfusion in late middle-age cognitively normal subjects. ApoE ε4 homozygous have reduced glucose metabolism in the same regions involved in AD. The aim of this study was to determine whether ApoE genotype might play a key-role in influencing the cerebral functional pattern as well as the degree of memory deficits in FTLD patients. METHODS: Fifty-two unrelated FTLD patients entered the study and underwent a somatic and neurological evaluation, laboratory examinations, a brain structural imaging study, and a brain functional Single Photon Emission Tomography study. ApoE genotype was determined. RESULTS: ApoE genotype influenced both clinical and functional features in FTLD. ApoE ε4-carriers were more impaired in long-term memory function (ApoE ε4 vs. ApoE non ε4, 6.3 ± 3.9 vs. 10.1 ± 4.2, p = 0.004) and more hypoperfused in uncus and parahippocampal regions (x,y,z = 38,-6,-20, T = 2.82, cluster size = 100 voxels; -32,-12,-28, T= 2.77, cluster size = 40 voxels). CONCLUSION: The present findings support the view that ApoE genotype might be considered a disease-modifying factor in FTLD, thus contributing to define a specific clinical presentation, and might be of relevance for pharmacological approaches

RITUAL, TIME, AND ENTERNITY

It is argued here that the construction of time and eternity are among ritual's entailments. In dividing continuous duration into distinct periods ritual distinguishes two temporal conditions: (1) that prevailing in mundane periods and (2) that prevailing during the intervals between them. Differences in the frequency, length, and relationship among the rituals constituting different liturgical orders are considered, as are differences between mundane periods and ritual's intervals with respect to social relations, cognitive modes, meaningfulness, and typical interactive frequencies. Periods, it is observed, relate to intervals as everchanging to never-changing, and close relationships of never changing to eternity, eternity to sanctity, and sanctity to truth are proposed. In the argument that ritual's “times out of time” really are outside mundane time, similarities to the operations of digital computers and Herbert Simon's discussion of interaction frequencies in the organization of matter are noted.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72989/1/j.1467-9744.1992.tb00996.x.pd

A biophysical representation of seagrass growth for application in a complex shallow-water biogeochemical model

Seagrasses are a critical component of the healthy functioning of many coastal marine ecosystems. Capturing the dynamics of seagrass communities requires both a detailed representation of processes such as seagrass nutrient uptake and photosynthesis, as well as models of light penetration, water column and sediment biogeochemical processes and other ecosystem characteristics that determine the environmental state. Here we develop a new two-state, 13-parameter seagrass model with the aim of providing sufficient detail to represent light and nutrient limitation, but simple enough to be coupled into a 60 state variable biogeochemical model. The novel formulation is built around a nitrogen-specific leaf area parameter, Ω, that is well-constrained and is used in calculating both the rate of photosynthesis and the fraction of the seafloor covered by seagrass, Aeff, where Aeff = 1 − exp(− ΩSGA) and SGA is the aboveground areal seagrass biomass. The model also contains terms for the uptake of nutrients from multiple layers of varying-porosity sediments, translocation of organic matter between leaves and roots, respiration and simple mortality terms. The model is applied to Gladstone Harbour, a macro-tidal sub-tropical estuary in northeast Australia, and is able to simulate realistic spatial seagrass distributions. A simplified form of the model is derived, which can be used to predict seagrass light-limited growth based on five measurable species-specific parameters (maximum growth rate, mortality rate, compensation irradiance, leaf blade angle and nitrogen-specific leaf area). The steady-state percent coverage of seagrass achieved at varying light levels and mortality intensity is calculated as a means of understanding the dynamics of the new seagrass model