Rationale and study design of a randomized, placebo-controlled, double-blind phase 2b trial to evaluate efficacy, safety, and tolerability of an oral glutaminyl cyclase inhibitor varoglutamstat (PQ912) in study participants with MCI and mild AD-VIVIAD

BACKGROUND

Varoglutamstat (formerly PQ912) is a small molecule that inhibits the activity of the glutaminyl cyclase to reduce the level of pyroglutamate-A-beta (pGluAB42). Recent studies confirm that pGluAB42 is a particular amyloid form that is highly synaptotoxic and plays a significant role in the development of AD.

METHODS

This paper describes the design and methodology behind the phase 2b VIVIAD-trial in AD. The aim of this study is to evaluate varoglutamstat in a state-of-the-art designed, placebo-controlled, double-blind, randomized clinical trial for safety and tolerability, efficacy on cognition, and effects on brain activity and AD biomarkers. In addition to its main purpose, the trial will explore potential associations between novel and established biomarkers and their individual and composite relation to disease characteristics.

RESULTS

To be expected early 2023 CONCLUSION: This state of the art phase 2b study will yield important results for the field with respect to trial methodology and for the treatment of AD with a small molecule directed against pyroglutamate-A-beta.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04498650.

HoloSelecta dataset: 10'035 GTIN-labelled product instances in vending machines for object detection of packaged products in retail environments

To assess the potential of current neural network architectures to reliably identify packaged products within a retail environment, we created an open-source dataset of 295 shelf images of vending machines with 10'035 labelled instances of 109 products. The dataset contains photos of vending machines by the provider Selecta, the largest European operator of vending machines. The vending machines are a mix of machines in public and private office spaces. The vending machines contain food as well as beverage products. The product instances in the vending machine images are labelled with bounding boxes, where a bounding box encapsulates the entire product with as little overlap as possible. The labels corresponding to the bounding box consist of a structured, human-readable labels including brand, product name and size as well as the GTIN of the product. The GTIN is the global standard to identify products in the retail environment and therefore increases the value as a dataset for the retail industry. Contrary to typical object detection datasets that choose labels at a higher level such as a can or bottle for a much wider variety of objects, this dataset chooses a far more detailed label that depends less on the shape but rather on the exact design of the product. The dataset falls into the category of object detection datasets with a large number of objects, which next to the GTIN label, represents a main differentiator of the dataset to other object detection datasets.

Use of benchmarking to monitor and analyze effects of herd size and herd milk yield on cattle health and welfare in Austrian dairy farms

The modernization and intensification of the dairy industry has led to larger herd sizes and higher milk production, both globally and in Austria. Benchmarking allows the monitoring of animal health and welfare as well as the identification of potential for improvement by comparing certain parameters with other farms with similar management environments. Using data from the Austrian routine recording system of various traits of milk production, fertility, and health, farmers and their veterinarians (with the consent of the farmer) can compare farm parameters with detailed data available from their district or state and ensure more efficient herd management. The aim of the present study was to provide an overview of dairy milk production in Austria based on the annual herd health reports and to examine the effects of herd size and milk production on fertility and health parameters. Annual herd health reports from all farms participating in the health monitoring system were considered, and analyses were conducted across breeds. A large variation between farms was observed. The results showed that, based on parameters of milk yield and herd size for the range of farms within this study, it cannot be concluded that these circumstances automatically lead to poor animal health. Farms with very small herd sizes differed significantly from those with larger herd sizes. Overall herd size effects were however small in Austria. Higher milk production based on a single farm does not necessarily cause more health and fertility problems; however, we detected a tendency for an increased risk of fertility, udder, and metabolic diagnoses. An active health management program might result in higher incidence rates for fertility or udder diagnoses, as a veterinary treatment might be economically superior if, for example, the calving interval can be shortened or the somatic cell count can be reduced. The results of the present study showed that it is advisable to use different benchmarks in combination for monitoring health, as well as for deciding on strategies to improve overall herd health management. Animal health reports on Austrian dairy cows are continuously being developed and new parameters integrated.

The German trial on Aciclovir and Corticosteroids in Herpes-simplex-virus-Encephalitis (GACHE): a multicenter, randomized, double-blind, placebo-controlled trial

Introduction

Comprehensive treatment of Herpes-simplex-virus-encephalitis (HSVE) remains a major clinical challenge. The current therapy gold standard is aciclovir, a drug that inhibits viral replication. Despite antiviral treatment, mortality remains around 20% and a majority of survivors suffer from severe disability. Experimental research and recent retrospective clinical observations suggest a favourable therapy response to adjuvant dexamethasone. Currently there is no randomized clinical trial evidence, however, to support the routine use of adjuvant corticosteroid treatment in HSVE.

Methods

The German trial of Aciclovir and Corticosteroids in Herpes-simplex-virus-Encephalitis (GACHE) studied the effect of adjuvant dexamethasone versus placebo on top of standard aciclovir treatment in adult patients aged 18 up to 85 years with proven HSVE in German academic centers of Neurology in a randomized and double blind fashion. The trial was open from November 2007 to December 2012. The initially planned sample size was 372 patients with the option to increase to up to 450 patients after the second interim analysis. The primary endpoint was a binary functional outcome after 6 months assessed using the modified Rankin scale (mRS 0-2 vs. 3-6). Secondary endpoints included mortality after 6 and 12 months, functional outcome after 6 months measured with the Glasgow outcome scale (GOS), functional outcome after 12 months measured with mRS and GOS, quality of life as measured with the EuroQol 5D instrument after 6 and 12 months, neuropsychological testing after 6 months, cranial magnetic resonance imaging findings after 6 months, seizures up to day of discharge or at the latest at day 30, and after 6 and 12 months.

Results

The trial was stopped prematurely for slow recruitment after 41 patients had been randomized, 21 of them treated with dexamethasone and 20 with placebo. No difference was observed in the primary endpoint. In the full analysis set (n = 19 in each group), 12 patients in each treatment arm achieved a mRS of 0-2. Similarly, we did not observe significant differences in the secondary endpoints (GOS, mRS, quality of life, neuropsychological testing).

Conclusion

GACHE being prematurely terminated demonstrated challenges encountered performing randomized, placebo-controlled trials in rare life threatening neurological diseases. Based upon our trial results the use of adjuvant steroids in addition to antiviral treatment remains experimental and is at the decision of the individual treating physician. Unfortunately, the small number of study participants does not allow firm conclusions.

Trial registration

EudraCT-Nr. 2005-003201-81.

Soft X-ray microscopy for probing of topical tacrolimus delivery via micelles

The penetration of topically applied tacrolimus formulated in micelles into murine skin is reported, measured by X-ray microscopy. Tacrolimus and micelles are probed for the first time by this high spatial resolution technique by element-selective excitation in the C 1s- and O 1s-regimes. This method allows selective detection of the distribution and penetration depth of drugs and carrier molecules into biologic tissues. It is observed that small, but distinct quantities of the drug and micelles, acting as a drug carrier, penetrate the stratum corneum. A comparison is made with the paraffin-based commercial tacrolimus ointment Protopic^®, where local drug concentrations show to be low. A slight increase in local drug concentration in the stratum corneum is observed, if tacrolimus is formulated in micelles, as compared to Protopic^®. This underscores the importance of the drug formulations for effective drug delivery. Time-resolved penetration shows presence of drug in the stratum corneum 100 min after formulation application, with penetration to deeper skin layers at 1000 min. High resolution micrographs give indications for a penetration pathway along the lipid membranes between corneocytes, but also suggest that the compound may penetrate corneocytes.

A Decision-support System for Real-time Risk Assessment of Airborne Spread of the Foot-and-Mouth Disease Virus

Objectives: The application of epidemic models during the first days following the confirmation of a virus outbreak should significantly contribute to minimize its costs. Here we describe the first version of a decision-support system for the calculation of the airborne spread of a virus and its application to foot-and-mouth disease (FMD). The goal is to provide geographical maps depicting infection risk for various animal species to support the national health authorities.

Methods: The major tool of the decision-support system is a specific epidemic (or atmospheric) model: A so-called Gaussian dispersion model to calculate 3-dimensional virus plumes. Additional tools providing input data and visualizing the output are: A veterinary data base of geo-referenced premises, a geographical information system (GIS), and, as an external part running at the National Weather Service, a numerical weather prediction (NWP) model. To demonstrate the features of the decision-support system a pilot study in Styria, Austria, has been performed simulating an artificial FMD outbreak.

Results: One result of this simulation experiment is the determination of neighboring premises at which animals are at risk to be infected. Particular attention has been turned to cattle, sheep and swine. Using actual hourly NWP data from April 25, 2003, and a source of ten swine excreting a virus, cattle have been estimated to be at risk downwind 1,000-12,000 m, sheep 200-1,300 m, and swines 70-330 m.

Conclusions: A system for real-time risk assessment of the airborne spread of a virus, applied to FMD, was introduced. Due to the forcing of the Gaussian dispersion model with NWP data, it is designed to run in both analysis and forecast mode. The system was applied for the first time during the Austrian real-time exercise on FMD, instructed by the European Union, in November 2004.

Fluorescence and Cerenkov luminescence imaging

This review addresses small animal optical imaging (OI) applications in diverse fields of basic research. In the past, OI has proven to be cost- and time-effective, allows real-time imaging as well as high-throughput analysis and does not imply the usage of ionizing radiation (with the exception of Cerenkov imaging applications). Therefore, this technique is widely spread – not only geographically, but also among very different fields of basic research – and is represented by a large body of publications. Originally used in oncology research, OI is nowadays emerging in further areas like inflammation and infectious disease as well as neurology. Besides fluorescent probe-based contrast, the feasibility of Cerenkov luminescence imaging (CLI) has been recently shown in small animals and thus represents a new route for future applications.

Thus, this review will focus on examples for OI applications in inflammation, infectious disease, cell tracking as well as neurology, and provides an overview over CLI.

Correlação entre as escalas analógica visual, de Glasgow, Colorado e Melbourne na avaliação de dor pós-operatória em cadelas submetidas à mastectomia total unilateral

RESUMO Objetivou-se correlacionar a necessidade de resgate analgésico pós-operatório por meio das escalas analógica visual (EVA), de Glasgow, Colorado e Melbourne, por meio de um avaliador experiente (AE) e outro não experiente (ANE), em cadelas submetidas à mastectomia unilateral total. Foram utilizadas 24 cadelas, hígidas, internadas 24 horas antes do procedimento cirúrgico, para avaliação do seu comportamento, com o auxílio das escalas descritas acima no momento basal (M0). Foram pré-medicadas com acepromazina e morfina (0,02 e 0,5mg/kg) e induzidas à anestesia geral com propofol (4mg/kg), mantidas em plano anestésico com CAM de isoflurano 1%. A manutenção analgésica transoperatória foi realizada com cetamina e fentanil (10µg/kg/min e 10µg/kg/h). As demais avaliações ocorreram em uma, duas, quatro, seis, oito, 12 e 24 horas de pós-operatório, sendo os resgates realizados com morfina (0,5mg/kg), pela via intramuscular, quando fosse observada uma pontuação maior ou igual a 50, seis, dois e nove pontos, respectivamente, para as escalas descritas, quando observada pelo AE e quando ao menos duas das escalas demonstrassem esses valores. Houve aumento dos escores de dor do M1 ao M12 para o AE e para o ANE para a EVA. Na análise de Colorado, maiores pontuações de dor ocorreram em relação ao M0 entre o M2 e o M8 para o AE e do M1 ao M12 para o ANE. Na análise de Glasgow, maiores escores foram detectados entre o M1 e o M12 para o AE e do M1 ao M24 para o ANE. E para a de Melbourne, maiores valores foram observados do M1 e do M24 para o AE e o ANE. A melhor correlação entre as escalas foi de 0,775 entre Glasgow e Colorado e entre os avaliadores de 0,925 para a Glasgow. Conclui-se que a escala de Glasgow apresentou-se mais sensível para detectar resgates analgésicos em cadelas submetidas à mastectomia total unilateral, que a inexperiência do avaliador não compromete a qualidade das avaliações de dor e sugere-se reduzir a pontuação da EVA e Melbourne para aumentar a sua capacidade em detectar resgates analgésicos pós-operatórios.

CXCR1 Regulates Pulmonary Anti-Pseudomonas Host Defense

Pseudomonas aeruginosa is a key opportunistic pathogen causing disease in cystic fibrosis (CF) and other lung diseases such as chronic obstructive pulmonary disease (COPD). However, the pulmonary host defense mechanisms regulating anti-P. aeruginosa immunity remain incompletely understood. Here we demonstrate, by studying an airway P. aeruginosa infection model, in vivo bioluminescence imaging, neutrophil effector responses and human airway samples, that the chemokine receptor CXCR1 regulates pulmonary host defense against P. aeruginosa. Mechanistically, CXCR1 regulates anti-Pseudomonas neutrophil responses through modulation of reactive oxygen species and interference with Toll-like receptor 5 expression. These studies define CXCR1 as a novel, noncanonical chemokine receptor that regulates pulmonary anti-Pseudomonas host defense with broad implications for CF, COPD and other infectious lung diseases.

Fluorescence and Cerenkov luminescence imaging. Applications in small animal research

This review addresses small animal optical imaging (OI) applications in diverse fields of basic research. In the past, OI has proven to be cost- and time-effective, allows real-time imaging as well as high-throughput analysis and does not imply the usage of ionizing radiation (with the exception of Cerenkov imaging applications). Therefore, this technique is widely spread - not only geographically, but also among very different fields of basic research - and is represented by a large body of publications. Originally used in oncology research, OI is nowadays emerging in further areas like inflammation and infectious disease as well as neurology. Besides fluorescent probe-based contrast, the feasibility of Cerenkov luminescence imaging (CLI) has been recently shown in small animals and thus represents a new route for future applications. Thus, this review will focus on examples for OI applications in inflammation, infectious disease, cell tracking as well as neurology, and provides an overview over CLI.

Nuchal Translucency Quality Review (NTQR) program: first one and half million results

OBJECTIVE

To evaluate the performance of first-trimester nuchal translucency (NT) measurement by providers (physician-sonologists and sonographers) within the Nuchal Translucency Quality Review (NTQR) program.

METHODS

After training and credentialing providers, the NTQR monitored performance of NT measurement by the extent to which an individual's median multiple of the normal median (MoM) for crown-rump length (CRL) was within the range 0.9-1.1 MoM of a published normal median curve. The SD of log10 MoM and regression slope of NT on CRL were also evaluated. We report the distribution between providers of these performance indicators and evaluate potential sources of variation.

RESULTS

Among the first 1.5 million scans in the NTQR program, performed between 2005 and 2011, there were 1 485 944 with CRL in the range 41-84 mm, from 4710 providers at 2150 ultrasound units. Among the 3463 providers with at least 30 scans in total, the median of the providers' median NT-MoMs was 0.913. Only 1901 (55%) had a median NT-MoM within the expected range; there were 89 above 1.1 MoM, 1046 at 0.8-0.9 MoM, 344 at 0.7-0.8 MoM and 83 below 0.7 MoM. There was a small increase in the median NT-MoM according to providers' length of time in the NTQR program and number of scans entered annually. On average, physician-sonologists had a higher median NT-MoM than did sonographers, as did those already credentialed before joining the program. The median provider SD was 0.093 and the median slope was 13.5%. SD correlated negatively with the median NT-MoM (r = -0.34) and positively with the slope (r = 0.22).

CONCLUSION

Even with extensive training, credentialing and monitoring, there remains considerable variability between NT providers. There was a general tendency towards under-measurement of NT compared with expected values, although more experienced providers had performance closer to that expected.

Antimicrobial drug use in Austrian pig farms: plausibility check of electronic on-farm records and estimation of consumption

Electronic drug application records from farmers from 75 conventional pig farms were revised and checked for their plausibility. The registered drug amounts were verified by comparing the farmers' records with veterinarians' dispensary records. The antimicrobial consumption was evaluated from 2008 to 2011 and expressed in weight of active substance(s), number of used daily doses (nUDD), number of animal daily doses (nADD) and number of product-related daily doses (nPrDD). All results were referred to one year and animal bodyweight (kg biomass). The data plausibility proof revealed about 14 per cent of unrealistic drug amount entries in the farmers' records. The annual antimicrobial consumption was 33.9 mg/kg/year, 4.9 UDD_kg/kg/year, 1.9 ADD_kg/kg/year and 2.5 PrDD_kg/kg/year (average). Most of the antimicrobials were applied orally (86 per cent) and at group-level. Main therapy indications were metaphylactic/prophylactic measures (farrow-to-finish and fattening farms) or digestive tract diseases (breeding farms). The proportion of the ‘highest priority critically important antimicrobials’ was low (12 per cent). After determination of a threshold value, farms with a high antimicrobial use could be detected. Statistical tests showed that the veterinarian had an influence on the dosage, the therapy indication and the active substance. Orally administered antimicrobials were mostly underdosed, parenterally administered antimicrobials rather correctly or overdosed.

Opposing effects of high- and low-molecular weight hyaluronan on CXCL12-induced CXCR4 signaling depend on CD44

The tumor microenvironment makes a decisive contribution to the development and dissemination of cancer, for example, through extracellular matrix components such as hyaluronan (HA), and through chemokines that regulate tumor cell behavior and angiogenesis. Here we report a molecular link between HA, its receptor CD44 and the chemokine CXCL12 in the regulation of cell motility and angiogenesis. High-molecular-weight HA (hHA) was found to augment CXCL12-induced CXCR4 signaling in both HepG2iso cells and primary human umbilical vein endothelial cells, as evidenced by enhanced ERK phosphorylation and increased cell motility. The augmentation of CXCR4 signaling translated into increased vessel sprouting and angiogenesis in a variety of assays. Small HA oligosaccharides (sHA) efficiently inhibited these effects. Both siRNA-mediated reduction of CD44 expression and antibodies that block the interaction of CD44 with HA provided evidence that CXCL12-induced CXCR4 signaling depends on the binding of hHA to CD44. Consistently, CD44 and CXCR4 were found to physically interact in the presence of CXCL12, an interaction that could be inhibited by sHA. These findings provide novel insights into how microenvironmental components interact with cell surface receptors in multi-component complexes to regulate key aspects of tumor growth and progression.

Exact alpha-error determination for two-stage sampling strategies to substantiate freedom from disease

Sampling strategies to substantiate freedom from disease are important when it comes to the trade of animals and animal products. When considering imperfect tests and finite populations, sample size calculation can, however, be a challenging task. The generalized hypergeometric formula developed by Cameron and Baldock (1998a) offers a framework that can elegantly be extended to multi-stage sampling strategies, which are widely used to account for disease clustering at herd-level. The achieved alpha-error of such surveys, however, typically depends on the realization of the sample and can differ from the pre-calculated value. In this paper, we introduce a new formula to evaluate the exact alpha-error induced by a specific sample. We further give a numerically viable approximation formula and analyze its properties using a data example of Brucella melitensis in the Austrian sheep population.

Serological, Bacteriological and Molecularbiological Survey of Paratuberculosis (Johne's Disease) in Austrian Cattle

Paratuberculosis (Johne's disease) is a chronic infectious disease of ruminants, caused by Mycobacterium avium subspecies paratuberculosis (MAP). Because of its long incubation period, high economic losses, difficulties in diagnosis and possible links to Morbus Crohn in humans, paratuberculosis is one of the most important diseases of ruminants today. An abattoir-based nationwide survey on the occurrence of MAP in the Austrian cattle population was performed using serology (SVANOVIR-ELISA) as well as culture, ZN-stain and IS900-PCR on faeces and lymph node samples. A total of 756 Austrian slaughter cattle were serologically, bacteriologically and molecularbiologically tested for the occurrence of MAP and specific antibodies respectively. Samples were collected following a statistical plan to obtain balanced specimens from the whole country. Nineteen per cent of the animals tested were serological positive, 10.1% gave an inconclusive result and 70.9% showed no specific antibodies against MAP. Only in four individuals MAP could be detected by stain, bacteriology or Polymerase Chain Reaction. The calculated prevalence of 19.0% positive cattle, each representing one farm, showing specific antibodies against MAP is rather high in terms of animal-level but low in herd level prevalence compared with other countries. When this study is compared with a similar study performed in Austria 1999, a significant increase of positive cattle and farms could be seen in Austria.

Dielectric properties of glycerol/water mixtures at temperatures between 10 and 50 degrees C

At six temperatures T between 10 and 50 degrees C and at mole fractions x(g) of glycerol (0<x(g)<or=0.9) the complex (electric) permittivity epsilon(nu) of glycerol/water mixtures has been measured as a function of frequency nu between 1 MHz and 40 GHz. The spectra of the glycerol/water mixtures can be well represented by a Davidson-Cole [J. Chem. Phys. 18, 1417 (1950)] relaxation function that reveals an unsymmetric relaxation time distribution. The effective dipole orientation correlation factor derived from the static permittivity displays an unspectacular behavior upon mixture composition. The dielectric relaxation time reveals a simple relation to the shear viscosity of the mixtures, but both quantities are not proportional to one another. The relaxation times at high temperatures nicely complement previously determined low temperature data, following a Vogel-Fulcher-Tammann-Hesse [Z. Phys. 22, 645 (1925); J. Am. Chem. Ceram. Soc. 8, 339 (1923); Z. Anorg. Allg. Chem. 156, 245 (1926)] (VFTH) temperature dependence. When the Eyring behavior is assumed a limiting high temperature form of the VFTH relation, enthalpy, and entropy of activation values are found which adopt significantly higher values in the glycerol rich mixtures than in the water rich liquids. The relaxation time distribution parameter at high water content indicates a dynamically heterogeneous structure of the liquids. Likely there exist glycerol rich and water rich microphases.

Ex vivo gingival-biofilm consortia

AIMS

To develop a protocol for harvesting ex vivo samples of gingival-biofilm consortia and to investigate their basic characteristics.

METHODS AND RESULTS

Gingival epithelial cells with attached biofilm were collected from healthy subjects by taking a smear. The bacterial viability was estimated via the alteration of the membrane permeability and metabolic activity via the double/single-stranded nucleic acid ratio using a confocal laser-scanning microscope. Morphological analysis was performed by scanning and transmission electron microscopy. Additionally, microbiological estimations were made. The electron microscopy revealed fimbriae-mediated adhesion and the formation of a biofilm matrix. Most bacteria were viable and had a high metabolic activity.

CONCLUSIONS

The presented study offers an easy to follow approach for harvesting samples of gingival-biofilm consortia. The latter differs considerably from the supragingival plaque in viability and zonal distribution. Related to free-living and in vitro-grown biofilms, the gingiva-associated biofilm revealed an atypically high metabolic activity.

SIGNIFICANCE AND IMPACT OF THE STUDY

Biofilm fragments should possess the basic features of the entire gingiva-associated biofilm; which as yet cannot be simulated in vitro. Thus, samples of ex vivo gingival-biofilm consortia can be used to investigate the resistance of oral biofilms against antibiotics and biocides.

Chlorhexidine-induced ultrastructural alterations in oral biofilm

Chlorhexidine, the most used biocide in periodontology, alters the permeability of the bacterial cell membrane. However, the chlorhexidine-induced morphological alterations in the oral biofilm have not been studied. To examine the effects of chlorhexidine on oral biofilm on an electron microscopic level, gingival epithelial cells with attached biofilm were collected from 10 volunteers, subjected to 0.1% chlorhexidine for 1 or 5 min, stained with ruthenium red-tetroxide, and analyzed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). SEM visualized the bacterial glycocalyces and the biofilm matrix on the biofilm surface; however, no chlorhexidine-induced alterations were observed. TEM revealed loss of bacterial membrane integrity and fimbrial disintegration in a few bacteria. In the proximity of these alterations, a restricted matrix disintegration was also observed. However, the chlorhexidine-induced alterations only effected a minor part of the oral biofilm and did not cause its disintegration. These findings suggest the insufficient efficiency of chlorhexidine against oral biofilm.

Multiple sclerosis gender issues: clinical practices of women neurologists

Substantially more women than men develop multiple sclerosis (MS), but information about the effects of MS and gender-specific issues such as pregnancy, breastfeeding, menstruation and hormone use is lacking. A survey study of neurologists' practice patterns was undertaken to elicit information about gender-specific topics and the use of disease-modifying MS therapies (DMT) including the interferons and glatiramer acetate (GA). A total of 147 surveys were returned. Half of respondents require patients to discontinue DMT during pregnancy, while 35% encourage discontinuation. Among those who allow patients to continue therapy, half consider GA to be safer during pregnancy than the interferons. Nearly 86% of respondents do not use DMT in patients who are breastfeeding. Among the 11% who actually prescribe during breastfeeding, most recommend GA. Neurologists generally leave the decision to breastfeed up to patients, and most refer patients to obstetrician/gynaecologists for counselling about contraception or hormone replacement therapy. The survey results described here provide insight into how neurologists manage reproductive health issues among women with MS.

A decision-support system for real-time risk assessment of airborne spread of the foot-and-mouth disease virus

OBJECTIVES

[corrected] The application of epidemic models during the first days following the confirmation of a virus outbreak should significantly contribute to minimize its costs. Here we describe the first version of a decision-support system for the calculation of the airborne spread of a virus and its application to foot-and-mouth disease (FMD). The goal is to provide geographical maps depicting infection risk for various animal species to support the national health authorities.

METHODS

The major tool of the decision-support system is a specific epidemic (or atmospheric) model: A so-called Gaussian dispersion model to calculate 3-dimensional virus plumes. Additional tools providing input data and visualizing the output are: A veterinary data base of geo-referenced premises, a geographical information system (GIS), and, as an external part running at the National Weather Service, a numerical weather prediction (NWP) model. To demonstrate the features of the decision-support system a pilot study in Styria, Austria, has been performed simulating an artificial FMD outbreak.

RESULTS

One result of this simulation experiment is the determination of neighboring premises at which animals are at risk to be infected. Particular attention has been turned to cattle, sheep and swine. Using actual hourly NWP data from April 25, 2003, and a source of ten swine excreting a virus, cattle have been estimated to be at risk downwind 1,000-12,000 m, sheep 200-1,300 m, and swines 70-330 m.

CONCLUSIONS

A system for real-time risk assessment of the airborne spread of a virus, applied to FMD, was introduced. Due to the forcing of the Gaussian dispersion model with NWP data, it is designed to run in both analysis and forecast mode. The system was applied for the first time during the Austrian real-time exercise on FMD, instructed by the European Union, in November 2004.

No association of clock gene T3111C polymorphism and affective disorders

CLOCK was hypothesised to be related to susceptibility of affective disorders. To test subsamples of affectively disordered patients, we examined age of onset (AoO), numbers of episodes and melancholic type of clinical manifestation. Using PCR and RFLP, we investigated in patients with unipolar depression and bipolar disorder (BP) whether the CLOCK T3111C SNP is associated with affective disorders (n=102) compared to healthy controls (n=103). No differences were found either in genotype or allele frequency distributions of T3111C polymorphism between patients compared to healthy controls (p>0.2). No deviations from Hardy-Weinberg Equilibrium (HWE) were detected either in patients, or healthy controls. Results suggest that there is no association between the T3111C SNP and affective disorders in general. Data of our sample replicate prior findings of Desan et al. [Am. J. Med. Genet. 12 (2000) 418]. Subsamples of patients with high numbers of affective episodes did show some deviations in genotypes (p=0.0585).

On-line anosognosia: Unawareness for chorea in real time but not on videotape delay

In hemiplegics, anosognosia (unawareness of deficit) rests on a mismatch between expected and actual movement: a feedback hypothesis emphasizes sensory deficits or neglect, a feedforward hypothesis postulates impaired intention to move. Anosognosia for other problems is less studied. The authors report a man without sensory deficits who was unaware of choreiform movements, except on videotape delay. The authors believe that a feed-forward mechanism underlies his "on-line" unawareness.

Kinetics of Ca2+ complexation with some carbohydrates in aqueous solutions

For solutions of four saccharides in water with alkaline-earth chlorides added ultrasonic attenuation spectra between 100 kHz and 2 GHz are reported and compared to those for carbohydrate solutions without salt. Calcium chloride does not alter the relaxation times in the spectra of D-glucose and D+-maltose solutions, reflecting the exocyclic hydroxymethyl group rotation, a saccharide-saccharide association, and, with the disaccharide, also motions of both rings of a molecule relative to one another. The spectra of D-xylose and D-fructose solutions are substantially changed by the salts. With both saccharides an additional term with relaxation time around some nanoseconds exists which is assigned to a rearrangement of a carbohydrate-cation complex. Other relaxation terms of these saccharide solutions are also subject to noticeable changes by the salt, indicating specific carbohydrate-cation interactions. The ultrasonic spectra show that such interactions may exist also with carbohydrates which do not display the particular hydroxyl group sequences that are considered to promote complexation with cations.

A polymorphism (5-HTTLPR) in the serotonin transporter promoter gene is associated with DSM-IV depression subtypes in seasonal affective disorder

Serotonergic mechanisms are thought to play an important role in the pathogenesis of seasonal affective disorder (SAD). The expression of the serotonin transporter (5-HTT) is regulated in part by an insertion/deletion polymorphism in the serotonin transporter gene promoter region (5-HTTLPR). The 5-HTTLPR short allele (s) has been associated with anxiety-related personality traits and depression, and one study observed an association between the 5-HTTLPR s-allele and SAD and the trait of seasonality. We genotyped 138 SAD patients and 146 healthy volunteers with low seasonality for 5-HTTLPR. No difference between patients and controls was found for genotype distribution and s-allele frequency. However, genotype distribution and allele frequencies were strongly associated with DSM-IV depression subtypes. Melancholic depression was associated with the 5-HTTLPR long (l) allele and atypical depression with the 5-HTTLPR s-allele (two-sided Fisher's exact test: genotype distribution: P=0.0038; allele frequencies: P=0.007). Our data are compatible with the hypothesis of a disease process that is not causally related to 5-HTTLPR, but involves 5-HT neurotransmission and 5-HTTLPR somewhere on its way to phenotypic disease expression.

Serum amyloid A in the serum and milk of ewes with mastitis induced experimentally with Staphylococcus epidermidis

Mastitis was induced experimentally in ewes with Staphylococcus epidermidis, and the concentrations of serum amyloid A (SAA) in milk and serum, and the somatic cell counts and bacteria in the milk were determined for up to 10 weeks in two experiments, each examining five infected and five control ewes. The somatic cell counts peaked eight hours after infection and preceded an increase in SAA in milk. A maximum concentration of 6460 microg/ml SAA was recorded in milk from the infected sheep, compared with a mean concentration of 1.4 microg/ml in the control sheep. The mean peak concentration of SAA in serum (206.8 microg/ml) occurred earlier (one day after infection) than in milk. The serum concentration of SAA in the healthy animals ranged from 0 to 29.4 microg/ml. There was no correlation between the concentrations of SAA in serum and milk.

The utility of computerized neuropsychological assessment of cognitive dysfunction in patients with relapsing-remitting multiple sclerosis

Traditional paper-and-pencil neuropsychological batteries used to document cognitive deficits in multiple sclerosis (MS) patients lack timing precision. This makes it difficult to accurately measure psychomotor slowing, a central cognitive symptom of MS. Additionally, traditional batteries lack multiple alternate forms necessary to control for practice effects when assessing cognition over time. Finally such batteries are lengthy and expensive. Computerized neuropsychological batteries address many of these shortcomings. They measure response time more precisely, require less administration time, include alternate forms, and are ideal for rapid screening/triage. Although there are normative data on the reliability and validity of computerized measures, there have been no controlled validation studies with MS patients. The current study was designed to validate a computerized neuropsychological battery (ANAM) for use with relapsing-remitting (RR) MS patients. Prior to initiation of interferon-beta-1a (Avonex) treatment, subjects participated in a neuropsychological evaluation consisting of traditional and computerized measures. Moderate-to-high correlations were found between computerized and traditional measures. Computerized tests accurately predicted performance on key traditional tests. The battery was also concordant with traditional measures in identifying RR MS patients with and without neurocognitive impairment. Findings are discussed with respect to increased accuracy and accessibility of neuropsychological evaluations for MS patients.

Alternate use of distinct intersubunit contacts controls GABAA receptor assembly and stoichiometry

GABA(A) receptors are the major inhibitory transmitter receptors in the CNS. Recombinant GABA(A) receptors composed of alpha(1)beta(3)gamma(2) subunits have been demonstrated to assemble as pentamers consisting of two alpha(1), two beta(3), and one gamma(2) subunit. Using truncated and chimeric alpha(1) subunits, we identified the alpha(1)(80-100) sequence as a major binding site for gamma(2) subunits. In addition, we demonstrated its direct interaction with gamma(2)(91-104), a sequence that previously has been identified to form the contact to alpha(1) subunits. The observation that the amino acid residues alpha(1)P96 and alpha(1)H101, which can be photolabeled by [(3)H]flunitrazepam, are located within or adjacent to the alpha(1)(80-100) sequence, indicates that the benzodiazepine binding site of GABA(A) receptors is located close to this intersubunit contact. The observation that alpha(1)(80-100) interacts with gamma(2) but not with beta(3) subunits indicates the existence of an additional beta(3) binding site on alpha(1) subunits. The preferred alternate use of the gamma(2) and beta(3) binding sites in two different alpha(1) subunits of the same receptor ensures the incorporation of only a single gamma(2) subunit and thus, determines subunit stoichiometry of alpha(1)beta(3)gamma(2) receptors. Distinct binding sites and their alternate use can therefore explain how subunits of hetero-oligomeric transmembrane proteins assemble into a defined protein complex.

Presenilin-dependent gamma-secretase processing of beta-amyloid precursor protein at a site corresponding to the S3 cleavage of Notch

The presenilin (PS)-dependent site 3 (S3) cleavage of Notch liberates its intracellular domain (NICD), which is required for Notch signaling. The similar gamma-secretase cleavage of the beta-amyloid precursor protein (betaAPP) results in the secretion of amyloid beta-peptide (Abeta). However, little is known about the corresponding C-terminal cleavage product (CTFgamma). We have now identified CTFgamma in brain tissue, in living cells, as well as in an in vitro system. Generation of CTFgamma is facilitated by PSs, since a dominant-negative mutation of PS as well as a PS gene knock out prevents its production. Moreover, gamma-secretase inhibitors, including one that is known to bind to PS, also block CTFgamma generation. Sequence analysis revealed that CTFgamma is produced by a novel gamma-secretase cut, which occurs at a site corresponding to the S3 cleavage of Notch.