Beyond factor analysis: Multidimensionality and the Parkinson’s Disease Sleep Scale-Revised

Many studies have sought to describe the relationship between sleep disturbance and cognition in Parkinson’s disease (PD). The Parkinson’s Disease Sleep Scale (PDSS) and its variants (the Parkinson’s disease Sleep Scale-Revised; PDSS-R, and the Parkinson’s Disease Sleep Scale-2; PDSS-2) quantify a range of symptoms impacting sleep in only 15 items. However, data from these scales may be problematic as included items have considerable conceptual breadth, and there may be overlap in the constructs assessed. Multidimensional measurement models, accounting for the tendency for items to measure multiple constructs, may be useful more accurately to model variance than traditional confirmatory factor analysis. In the present study, we tested the hypothesis that a multidimensional model (a bifactor model) is more appropriate than traditional factor analysis for data generated by these types of scales, using data collected using the PDSS-R as an exemplar. 166 participants diagnosed with idiopathic PD participated in this study. Using PDSS-R data, we compared three models: a unidimensional model; a 3-factor model consisting of sub-factors measuring insomnia, motor symptoms and obstructive sleep apnoea (OSA) and REM sleep behaviour disorder (RBD) symptoms; and, a confirmatory bifactor model with both a general factor and the same three sub-factors. Only the confirmatory bifactor model achieved satisfactory model fit, suggesting that PDSS-R data are multidimensional. There were differential associations between factor scores and patient characteristics, suggesting that some PDSS-R items, but not others, are influenced by mood and personality in addition to sleep symptoms. Multidimensional measurement models may also be a helpful tool in the PDSS and the PDSS-2 scales and may improve the sensitivity of these instruments

Model fit indices for the 1 factor CFA, the 3 factor CFA and the confirmatory bifactor model.

<p>Model fit indices for the 1 factor CFA, the 3 factor CFA and the confirmatory bifactor model.</p

Diagram of confirmatory bifactor model: Regression coefficients for all significant paths.

<p>Squares represent measured variables, circles represent latent variables, curved lines are where we have allowed covariance of error terms to improve model fit.</p

Correlations between confirmatory bifactor model factor scores and participant characteristics.

<p>Correlations between confirmatory bifactor model factor scores and participant characteristics.</p

Means, standard deviations and standardised factor loadings for PDSS-R data.

<p>Means, standard deviations and standardised factor loadings for PDSS-R data.</p

The value of antimicrobial peptides in the age of resistance.

Accelerating growth and global expansion of antimicrobial resistance has deepened the need for discovery of novel antimicrobial agents. Antimicrobial peptides have clear advantages over conventional antibiotics which include slower emergence of resistance, broad-spectrum antibiofilm activity, and the ability to favourably modulate the host immune response. Broad bacterial susceptibility to antimicrobial peptides offers an additional tool to expand knowledge about the evolution of antimicrobial resistance. Structural and functional limitations, combined with a stricter regulatory environment, have hampered the clinical translation of antimicrobial peptides as potential therapeutic agents. Existing computational and experimental tools attempt to ease the preclinical and clinical development of antimicrobial peptides as novel therapeutics. This Review identifies the benefits, challenges, and opportunities of using antimicrobial peptides against multidrug-resistant pathogens, highlights advances in the deployment of novel promising antimicrobial peptides, and underlines the needs and priorities in designing focused development strategies taking into account the most advanced tools available

The relationship between sleep and cognition in Parkinson's disease: A meta-analysis

© 2015 Elsevier Ltd. It is well established that sleep disorders have neuropsychological consequences in otherwise healthy people. Studies of night-time sleep problems and cognition in Parkinson's disease (PD), however, paint a mixed picture, with many reporting no relationship between sleep problems and neuropsychological performance. This review aimed to meta-analyse this research and to examine the factors underlying these mixed results. A literature search was conducted of published and unpublished studies, resulting in 16 papers that met inclusion criteria. Data were analysed in the domains of: global cognitive function; memory (general, long-term verbal recognition, long-term verbal recall); and executive function (general, shifting, updating, inhibition, generativity, fluid reasoning). There was a significant effect of sleep on global cognitive function, long-term verbal recall, long-term verbal recognition, shifting, updating, generativity, and fluid reasoning. Although there are effects on memory and executive function associated with poor sleep in PD, the effects were driven by a small number of studies. Numerous methodological issues were identified. Further studies are needed reliably to determine whether disturbed sleep impacts on cognition via mechanisms of hypoxia, hypercapnia, sleep fragmentation, chronic sleep debt or decreased REM and/or slow wave sleep in PD, as this may have important clinical implications

Antimicrobial and Cell-Penetrating Peptides: How to Understand Two Distinct Functions Despite Similar Physicochemical Properties

Antimicrobial and cell-penetrating peptides are both classes of membrane-active peptides sharing similar physicochemical properties. Both kinds of peptides have attracted much attention owing to their specific features. AMPs disrupt cell membranes of bacteria and display urgently needed antibiotic substances with alternative modes of action. Since the multidrug resistance of bacterial pathogens is a more and more raising concern, AMPs have gained much interest during the past years. On the other side, CPPs enter eukaryotic cells without substantially affecting the plasma membrane. They can be used as drug delivery platforms and have proven their usefulness in various applications. However, although both groups of peptides are quite similar, their intrinsic activity is often different, and responsible factors are still in discussion. The aim of this chapter is to summarize and shed light on recent findings and concepts dealing with differences and similarities of AMPs and CPPs and to understand these different functions