The effects of highly active antiretroviral therapy (HAART) on neuropsychological status in HIV-infection: A prospective study.

The advent of highly active antiretroviral therapy (HAART) has resulted in significant reductions in HIV morbidity and mortality but the longitudinal effects on cognition are less well known. This longitudinal study examined the effects of highly active antiretroviral therapy (HAART) on cognitive performance in adults with HIV. Three hundred eighty-six adults representing all stages of HIV disease were tested at baseline and 180 of those subjects underwent a follow-up assessment. Subjects who were on HAART outperformed subjects on a non-HAART regimen, and those taking no antiretroviral medications, on the Grooved Pegboard Test, and were less impaired overall, at Time 1 and Time 2. Trends in the expected direction were found on other tests of psychomotor speed as well as on tests of attention and learning efficiency, however the group mean methodology failed to identify the breadth and depth of individual cognitive impairment across this sample. Longitudinal analyses using Reliable Change Indices indicated that 65% of the HIV-positive subjects had a stable cognitive profile during the follow-up time frame while 10% exhibited improved cognitive functioning and 26% deteriorated. Although there was a definite relationship between HAART and immune reconstitution, as well as HAART and viral suppression, a clear association between HAART and cognitive improvement was not identified. When the sample was restricted to individuals with CD4 cell counts \u3c 200 mul, HAART was associated with cognitive change on selected measures of attention, psychomotor speed, learning efficiency and abstraction. Cognitive improvement was predicted by a model consisting of immune system response, initial cognitive impairment level, and estimated IQ. These findings suggest that the long-term effect of HAART on cognition is mediated by multiple factors. The dissociation between systemic and neurocognitive response to HAART that was identified in the current study supports a model of immune system-mediated cognitive disruption in HIV. As individuals with HIV survive longer, and potentially experience more cognitive impairment, more longitudinal research of this type is necessary to investigate the neurocognitive sequelae of HIV and response to HAART. Source: Dissertation Abstracts International, Volume: 67-07, Section: B, page: 4106. Thesis (Ph.D.)--University of Windsor (Canada), 2006

Objective measurement of cough frequency during COPD exacerbation convalescence

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Cough and sputum production are associated with adverse outcomes in COPD and are common during COPD exacerbation (AE-COPD). This study of objective cough monitoring using the Hull Automated Cough Counter and Leicester Cough Monitor software confirms that this system has the ability to detect a significant decrease in cough frequency during AE-COPD convalescence. The ability to detect clinically meaningful change indicates a potential role in home monitoring of COPD patients

Continuous cough monitoring using ambient sound recording during convalescence from a COPD exacerbation

Purpose Cough is common in chronic obstructive pulmonary disease (COPD) and is associated with frequent exacerbations and increased mortality. Cough increases during acute exacerbations (AE-COPD), representing a possible metric of clinical deterioration. Conventional cough monitors accurately report cough counts over short time periods. We describe a novel monitoring system which we used to record cough continuously for up to 45 days during AE-COPD convalescence. Methods This is a longitudinal, observational study of cough monitoring in AE-COPD patients discharged from a single teaching-hospital. Ambient sound was recorded from two sites in the domestic environment and analysed using novel cough classifier software. For comparison, the validated hybrid HACC/LCM cough monitoring system was used on days 1, 5, 20 and 45. Patients were asked to record symptoms daily using diaries. Results Cough monitoring data were available for 16 subjects with a total of 568 monitored days. Daily cough count fell significantly from mean±SEM 272.7±54.5 on day 1 to 110.9±26.3 on day 9 (p<0.01) before plateauing. The absolute cough count detected by the continuous monitoring system was significantly lower than detected by the hybrid HACC/LCM system but normalised counts strongly correlated (r=0.88, p<0.01) demonstrating an ability to detect trends. Objective cough count and subjective cough scores modestly correlated (r=0.46). Conclusions Cough frequency declines significantly following AE-COPD and the reducing trend can be detected using continuous ambient sound recording and novel cough classifier software. Objective measurement of cough frequency has the potential to enhance our ability to monitor the clinical state in patients with COPD

Expression and Localization of an Hsp70 Protein in the Microsporidian Encephalitozoon cuniculi

Microsporidia spore surface proteins are an important, under investigated aspect of spore/host cell attachment and infection. For comparison analysis of surface proteins, we required an antibody control specific for an intracellular protein. An endoplasmic reticulum-associated heat shock protein 70 family member (Hsp70; ECU02 0100; C1 ) was chosen for further analysis. DNA encoding the C1 hsp70 was amplified, cloned and used to heterologously express the C1 Hsp70 protein, and specific antiserumwas generated. Two-dimensional Western blotting analysis showed that the purified antibodies were monospecific. Immunoelectron microscopy of developing and mature E. cuniculi spores revealed that the protein localized to internal structures and not to the spore surface. In spore adherence inhibition assays, the anti-C1 antibodies did not inhibit spore adherence to host cell surfaces, whereas antibodies to a known surface adhesin (EnP1) did so. In future studies, the antibodies to the \u27C1\u27 Hsp70 will be used to delineate spore surface protein expression

Place Field Repetition and Purely Local Remapping in a Multicompartment Environment

Hippocampal place cells support spatial memory using sensory information from the environment and self-motion information to localize their firing fields. Currently, there is disagreement about whether CA1 place cells can use pure self-motion information to disambiguate different compartments in environments containing multiple visually identical compartments. Some studies report that place cells can disambiguate different compartments, while others report that they do not. Furthermore, while numerous studies have examined remapping, there has been little examination of remapping in different subregions of a single environment. Is remapping purely local or do place fields in neighboring, unaffected, regions detect the change? We recorded place cells as rats foraged across a 4-compartment environment and report 3 new findings. First, we find that, unlike studies in which rats foraged in 2 compartments, place fields showed a high degree of spatial repetition with a slight degree of rate-based discrimination. Second, this repetition does not diminish with extended experience. Third, remapping was found to be purely local for both geometric change and contextual change. Our results reveal the limited capacity of the path integrator to drive pattern separation in hippocampal representations, and suggest that doorways may play a privileged role in segmenting the neural representation of space

Primary Factors Responsible for the Present Business Standing of the Northern Wholesale Hardware Company

102 pagesIt is the purpose of this thesis to show what factors are responsible for the success and development of the Northern Wholesale Hardware Company, a cooperative retail buying association. It may be well to point out these factors by determining to what extent, if at all, the whole cell functions of selling, buying, credit, delivery, and storage are performed by this company; And, also, to further the appraisal by pointing out its advantages and disadvantages. The history and present status of the cooperative retail buying association movement is first described in developing this thesis. This is followed by a discussion of the history, organization and wholesale functions performed by the Northern Wholesale Hardware Company. In each chapter on the wholesale functions of this company a comparison is drawn with drug and grocery cooperatives, as well as others in the hardware field. The material for this thesis was obtained from several sources. Much of it was gathered through members and officials of the company by questionnaires, private interviews, and correspondence. A second source was books and magazine articles on cooperative wholesaling. As a final source, such material as the Federal Trade Commission reports, information obtained from other governmental agencies, and interviews with regular wholesale hardware firms was utilized in the formulation of this study

Magnetic Resonance Imaging Pilot Study of Intravenous Glyburide in Traumatic Brain Injury.

Pre-clinical studies of traumatic brain injury (TBI) show that glyburide reduces edema and hemorrhagic progression of contusions. We conducted a small Phase II, three-institution, randomized placebo-controlled trial of subjects with TBI to assess the safety and efficacy of intravenous (IV) glyburide. Twenty-eight subjects were randomized and underwent a 72-h infusion of IV glyburide or placebo, beginning within 10 h of trauma. Of the 28 subjects, 25 had Glasgow Coma Scale (GCS) scores of 6-10, and 14 had contusions. There were no differences in adverse events (AEs) or severe adverse events (ASEs) between groups. The magnetic resonance imaging (MRI) percent change at 72-168 h from screening/baseline was compared between the glyburide and placebo groups. Analysis of contusions (7 per group) showed that lesion volumes (hemorrhage plus edema) increased 1036% with placebo versus 136% with glyburide (p = 0.15), and that hemorrhage volumes increased 11.6% with placebo but decreased 29.6% with glyburide (p = 0.62). Three diffusion MRI measures of edema were quantified: mean diffusivity (MD), free water (FW), and tissue MD (MDt), corresponding to overall, extracellular, and intracellular water, respectively. The percent change with time for each measure was compared in lesions (n = 14) versus uninjured white matter (n = 24) in subjects receiving placebo (n = 20) or glyburide (n = 18). For placebo, the percent change in lesions for all three measures was significantly different compared with uninjured white matter (analysis of variance [ANOVA], p < 0.02), consistent with worsening of edema in untreated contusions. In contrast, for glyburide, the percent change in lesions for all three measures was not significantly different compared with uninjured white matter. Further study of IV glyburide in contusion TBI is warranted

The Schwarzian derivative and the Wiman-Valiron property

Consider a transcendental meromorphic function in the plane with finitely many critical values, such that the multiple points have bounded multiplicities and the inverse function has finitely many transcendental singularities. Using the Wiman-Valiron method it is shown that if the Schwarzian derivative is transcendental then the function has infinitely many multiple points, the inverse function does not have a direct transcendental singularity over infinity, and infinity is not a Borel exceptional value. The first of these conclusions was proved by Nevanlinna and Elfving via a fundamentally different method