Short-term risk prediction after major lower limb amputation: PERCEIVE study

BACKGROUND

The accuracy with which healthcare professionals (HCPs) and risk prediction tools predict outcomes after major lower limb amputation (MLLA) is uncertain. The aim of this study was to evaluate the accuracy of predicting short-term (30 days after MLLA) mortality, morbidity, and revisional surgery.

METHODS

The PERCEIVE (PrEdiction of Risk and Communication of outcomE following major lower limb amputation: a collaboratIVE) study was launched on 1 October 2020. It was an international multicentre study, including adults undergoing MLLA for complications of peripheral arterial disease and/or diabetes. Preoperative predictions of 30-day mortality, morbidity, and MLLA revision by surgeons and anaesthetists were recorded. Probabilities from relevant risk prediction tools were calculated. Evaluation of accuracy included measures of discrimination, calibration, and overall performance.

RESULTS

Some 537 patients were included. HCPs had acceptable discrimination in predicting mortality (931 predictions; C-statistic 0.758) and MLLA revision (565 predictions; C-statistic 0.756), but were poor at predicting morbidity (980 predictions; C-statistic 0.616). They overpredicted the risk of all outcomes. All except three risk prediction tools had worse discrimination than HCPs for predicting mortality (C-statistics 0.789, 0.774, and 0.773); two of these significantly overestimated the risk compared with HCPs. SORT version 2 (the only tool incorporating HCP predictions) demonstrated better calibration and overall performance (Brier score 0.082) than HCPs. Tools predicting morbidity and MLLA revision had poor discrimination (C-statistics 0.520 and 0.679).

CONCLUSION

Clinicians predicted mortality and MLLA revision well, but predicted morbidity poorly. They overestimated the risk of mortality, morbidity, and MLLA revision. Most short-term risk prediction tools had poorer discrimination or calibration than HCPs. The best method of predicting mortality was a statistical tool that incorporated HCP estimation.

Functional lasing microcapillaries for surface-specific sensing

Lasing-based sensors have several advantages over fluorescent devices, specifically related to the high light intensity and narrow mode linewidth that can improve the speed and accuracy of the sensor performance. In this work, a microcapillary-based lasing sensor is demonstrated, in which the lasing wavelengths are sensitive to the surface binding of specific materials. In order to achieve this, we utilized lasing into the "star" and "triangle" modes of a conventional microcapillary and tracked the mode positions after the deposition of a polyelectrolyte tri-layer and the subsequent amide binding of carboxy-functionalized polystyrene microspheres. While the lasing mode spectrum becomes increasingly complicated by the addition of the surface layers, careful mode selection can be used to monitor the layer-by-layer surface binding in a mechanically and optically robust device. For polystyrene microspheres, the detection limits were 9.75 nM based upon the lasing mode shift, which compares favorably with fluorescence-based devices. The methods presented in this work could readily be extended to other surface binding schemes and lasing wavelengths, showing that capillary microlasers could be used for many potential applications that capitalize on stable lasing-based detection methods.

Dental students' and staff perceptions of the impact of learning environment disruption on their learning and teaching experiences

INTRODUCTION

This project is a qualitative investigation into student and staff experiences of the effect of a major building redevelopment on their Dental School learning and teaching environments. Currently, there is little research exploring the impact of disruptions to the learning environment on students' learning and staff teaching experiences.

METHOD

Data were collected in 2016 using an online survey, semi-structured interviews and focus groups with students and staff. Data were analysed using a general inductive approach.

RESULTS

Four broad themes emerged as follows: (i) students valued having a space for personal and collaborative work within the Dental School; (ii) both staff and students positioned staff contributions to learning experiences above the role of the physical learning environment; (iii) the majority of staff and students not feel that the physical environment limited their clinical training; and (iv) staff and students were able to adapt to the impact of building redevelopment through resilience and organisation.

DISCUSSION

Results of this research have informed the provision of collegial spaces at the School, both as the building redevelopment continues, and in planning for the completed building.

How do educators in one New Zealand undergraduate Bachelor of Oral Health course teach and nurture professionalism?

INTRODUCTION

Research on integrated dental hygiene and dental therapy courses is scarce; studies reporting on how staff in these combined scope courses teach professionalism are even more scarce. This study aimed to partially fill these research gaps.

METHOD AND MATERIALS

In 2016, online surveys were sent to 34 staff members who taught into the integrated Bachelor of Oral Health (BOH) course at the University of Otago's Faculty of Dentistry; 13 were returned. Two focus groups were conducted with six BOH educators.

RESULTS

Aspects of professionalism were taught and nurtured in the formal curriculum, the clinic and the informal curriculum. In the formal curriculum, policies outlining the professional standards of behaviour expected of oral health practitioners and students in New Zealand and the Faculty were discussed. In the clinic, educators taught professionalism through modelling clinical skills, assessing students' performance and commenting on their reflective logbooks. In the informal curriculum, BOH teachers nurtured professionalism through discussions about standards of behaviour outside of the university. Role modelling was the most common method that participants reported they taught or nurtured professionalism in their students.

DISCUSSION

Professionalism is a complex concept that is taught and nurtured in a number of ways over all aspects of the course.

CONCLUSION

Oral Health educators need to maintain a high standard of professionalism when interacting with students and patients, as well as in public spaces, in order to model professionalism to their students.

Wide-gamut lasing from a single organic chromophore

The development of wideband lasing media has deep implications for imaging, sensing, and display technologies. We show that a single chromophore can be engineered to feature wide-gamut fluorescence and lasing throughout the entire visible spectrum and beyond. This exceptional color tuning demonstrates a chemically controlled paradigm for light emission applications with precise color management. Achieving such extensive color control requires a molecular blueprint that yields a high quantum efficiency and a high solubility in a wide variety of liquids and solids while featuring a heterocyclic structure with good steric access to the lone pair electrons. With these requirements in mind, we designed a lasing chromophore that encloses a lasing color space twice as large as the sRGB benchmark. This record degree of color tuning can in principle be adapted to the solid state by incorporating the chromophore into polymer films. By appropriately engineering the base molecular structure, the widest range of lasing wavelengths observed for a conventional gain medium can be achieved, in turn establishing a possible route toward high-efficiency light emitters and lasers with near-perfect chromaticity.

Resin Infiltration of Caries in Primary Molars in a Community Setting: 24-Month Randomized Controlled Trial Findings

This study aimed to assess whether resin infiltration of primary molar proximal lesions is more effective than noninvasive measures in radiographically controlling carious lesion progression into the dentin. A split-mouth randomized controlled trial included 90 children, each with 2 proximal lesions confined to the inner half of the enamel or ≤0.5 mm into the dentin. For each child, lesions were randomly allocated to test (infiltration: DMG Icon preproduct and fluoride varnish) or control (fluoride varnish) status. The primary outcome measure was 24-mo radiographic lesion progression. Placement of a restoration during the study period was counted as lesion progression. Proportions of teeth with progressed lesions were compared using the McNemar test. Children also reported on the treatment's acceptability to them. Children (46% female) ranged in age from 6 to 9 y. Their mean number of decayed, missing, and filled teeth (d₃mft) was 2.8 (SD 2.6). At baseline, 58% and 42% of children were at moderate and low risk, respectively. Test and control lesions presented with similar radiographic lesions at baseline. At the 24-mo follow-up, 6 children had moved and 30 teeth had exfoliated. In the test and control groups, 15 of 66 lesions (22.7%) and 30 of 69 lesions (43.5%) had progressed, respectively (P < 0.05). The 2-y therapeutic effect (based on pairwise radiographic readings) of infiltration over fluoride varnish was 20.8% (95% confidence interval, 10.6%-30.2%). Nearly all children (96.7%) had enjoyed their visit to the clinic, and more than two-thirds (72.2%) were not worried about returning for treatment. Infiltration is more efficacious than fluoride varnish for controlling carious lesion progression in proximal lesions in primary molars, and most children find the treatment acceptable (Australian New Zealand Clinical Trials Registry ANZCTR.org.au ACTRN12611000827932). Knowledge Transfer Statement: These study findings can help clinicians decide which caries management approach they wish to use to prevent progression of proximal lesions in primary molars. With consideration of cost and patient preference, this information could lead to more appropriate therapeutic decisions.

Refractometric sensitivity and thermal stabilization of fluorescent core microcapillary sensors: theory and experiment

Fluorescent-core microcapillaries (FCMs) present a robust basis for the application of optical whispering gallery modes toward refractometric sensing. An important question concerns whether these devices can be rendered insensitive to local temperature fluctuations, which may otherwise limit their refractometric detection limits, mainly as a result of thermorefractive effects. Here, we first use a standard cylindrical cavity formalism to develop the refractometric and thermally limited detection limits for the FCM structure. We then measure the thermal response of a real device with different analytes in the channel and compare the result to the theory. Good stability against temperature fluctuations was obtained for an ethanol solvent, with a near-zero observed thermal shift for the transverse magnetic modes. Similarly good results could in principle be obtained for any other solvent (e.g., water), if the thickness of the fluorescent layer can be sufficiently well controlled.

Protein biosensing with fluorescent microcapillaries

Capillaries with a high-index fluorescent coating represent a new type of whispering-gallery-mode (WGM) microcavity sensor. By coating silicon quantum dots (Si-QDs) onto the channel wall of a microcapillary, a cylindrical microcavity forms in which the optical confinement arises from the index contrast at the interface between the QD layer and the glass capillary wall. However, the ability to functionalize the QD layer for biosensing applications is an open question, since the layer consists of a mixture of Si-QDs embedded in a glassy SiOx matrix. Here, we employ a polyelectrolyte (PE) multilayer approach to functionalize the microcapillary inner surface and demonstrate the potential of this refractive index sensing platform for label-free biosensing applications, using biotin-neutravidin as a specific interaction model.

Transparency and stability of Ag-based metal-dielectric multilayers

We fabricated and tested periodic metal (Ag)-dielectric (SiO2 or TiO2) multilayers with transparency bands in the visible range. For samples with Ag-TiO2 interfaces, the optical properties exhibited relatively poor predictability, likely due to oxidation of the Ag layers. Ag/SiO2-based multilayers were found to be more predictable and stable, but the relatively low refractive index of SiO2 limits their inherent transparency and pass-band bandwidth. We show that termination of the multilayer with a single high-index layer reduces the admittance mismatch with the ambient media, and thus improves the properties of the transparency band.

Ultimate resolution for refractometric sensing with whispering gallery mode microcavities

Many proposed microfluidic biosensor designs are based on the measurement of the resonances of an optical microcavity. Fluorescence-based resonators tend to be simpler and more robust than setups that use evanescent coupling from tuneable laser to probe the cavity. In all sensor designs the detection limits depend on the wavelength resolution of the detection system, which is a limitation of fluorescence-based devices. In this work, we explore the ultimate resolution and detection limits of refractometric microcavity sensor structures. Because many periodic modes are collected simultaneously from fluorescent resonators, standard Fourier methods can be best suited for rapid and precise analysis of the resonance shifts. Simple numerical expressions to calculate the ultimate sensor resolution and detection limits were found, and the results compared to experiments in which the resonances of fluorescent-core microcapillaries responded to various sucrose concentrations in water.

Refractometric sensing with fluorescent-core microcapillaries

Capillaries present a promising structure for microfluidic refractive index sensors. We demonstrate a capillary-type fluorescent core microcavity sensor based on whispering gallery mode (WGM) resonances. The device consists of a microcapillary having a layer of fluorescent silicon quantum dots (QDs) coated on the channel surface. The high effective index of the QD layer confines the electric field near the capillary channel and causes the development of WGM resonances in the fluorescence spectrum. Solutions consisting of sucrose dissolved in water were pumped through the capillary while the fluorescence WGMs were measured with a spectrometer. The device showed a refractometric sensitivity of 9.8 nm/RIU (up to 13.8 nm/RIU for higher solution refractive index) and a maximum detection limit of ~7.2 x 10(-3) RIU. Modeling the field inside the capillary structure, which is analogous to a layered hollow ring resonator, shows that sensitivities as high as 100 nm/RIU and detection limits as low as ~10(-5) RIU may be achievable by optimizing the QD film thickness.

High-finesse cavities fabricated by buckling self-assembly of a-Si/SiO2 multilayers

Arrays of half-symmetric Fabry-Perot micro-cavities were fabricated by controlled formation of circular delamination buckles within a-Si/SiO(2) multilayers. Cavity height scales approximately linearly with diameter, in reasonable agreement with predictions based on elastic buckling theory. The measured finesse (F > 10(3)) and quality factors (Q > 10(4) in the 1550 nm range) are close to reflectance limited predictions, indicating that the cavities have low roughness and few defects. Degenerate Hermite-Gaussian and Laguerre-Gaussian modes were observed, suggesting a high degree of cylindrical symmetry. Given their silicon-based fabrication, these cavities hold promise as building blocks for integrated optical sensing systems.

The Formation of High-Coercivity, Oriented, Nanophase Cobalt Precipitates in Al2O3 Single Crystals by Ion Implantation

Ion-implantation and thermal-processing methods have been used to form nanophase magnetic precipitates of metallic cobalt that are embedded in the near-surface region of single crystals of Al2O3. The Co precipitates are isolated, single-crystal particles that are crystallographically oriented with respect to the host Al2O3 lattice. Embedded nanophase Co precipitates were formed by the implantation of Co+ at an energy of 140 keV and a dose of 8 × 1016 ions/cm2 followed by annealing in a reducing atmosphere. The implanted/annealed Co depth profile, particle size distributions and shapes, and the orientational relationship between the nanophase precipitates and the host crystal lattice were determined using RBS/channeling, transmission electron microscopy, and x-ray diffraction. Magneto-optical effects arising from Co precipitates formed in the near-surface region of Al2O3 were observed and characterized using magnetic circular dichroism. Magnetic properties of the Co-particle/host nanocomposites were investigated in the temperature range of 77 to 295 K in applied fields of up to 10 kG using a superconducting quantum interference device (SQUID) magnetometer. Implantation of the Co particles by Pt or Xe ions produced a large anisotropic increase in their coercivity. Accordingly, these magnetic nanoparticle systems may be of interest for magnetic data storage applications. Details of the magnetic properties of the Co/Al2O3 nanocomposites including their retentivity, coercivity, saturation field, and magnetic anisotropy are presented.

Electron-Irradiation-Induced Crystallization of Amorphous Orthophosphates

Amorphous LaPO4, EuPO4, GdPO4, ScPO4, LuPO4, and fluorapatite [Ca5(PO4)3F] were irradiated by the electron beam in a transmission electron microscope. Irradiations were performed over a range of temperatures from −150 to 300 °C, electron energies from 80 to 200 keV, and current densities from 0.3 to 16 A/cm2. In all cases, the materials crystallized to form a randomly oriented polycrystalline assemblage. Crystallization is driven dominantly by inelastic processes, although ballistic collisions with the target nuclei can become important at energies higher than 175 keV, particularly in apatite. Using a high current density, crystallization is so fast that continuous lines of crystallites can be “drawn” on the amorphous matrix.

Ion-Implantation/Annealing-Induced Precipitation of Nanophase Ferromagnetic Particles In Yttrium-Stabilized ZrO2

Ion implantation and thermal processing techniques have been used to form embedded ferromagnetic nanophase precipitates and thereby create magneto-optically active near-surface regions on otherwise inactive materials. Ferromagnetic precipitates were formed by first implanting Fe+ or Ni− into Y0.15Zr0.85O1.93(YSZ) with an implant energy of 140 keV, a fluence of 8.0 × 1016 ions/cm2, and at a temperature of-189°C. After implantation, the specimens were annealed at temperatures ranging from 500 to 1100°C in several types of reducing atmospheres. X-ray diffraction and TEM analysis of the Fe- or Ni-implanted/annealed specimens revealed that crystallographically coherent precipitates of metallic α-Fe, magnetite (Fe3O4), or Ni could be formed in YSZ depending on the annealing conditions. In particular, the cooling rate was established as the critical factor that determined whether Fe or Fe3O4 precipitates were created. Magneto-optical effects arising from ferromagnetic precipitates of Fe, Fe3O4, and Ni in the near-surface region of YSZ were observed and characterized using magnetic circular dichroism (MCD). The magneto-optical response of the α-Fe, Fe3O4, and Ni precipitates was markedly different as indicated by the MCD-detected hysteresis curves. The precipitation mechanism, the chemical nature of the precipitates, and the particle-size distributions resulting from different annealing conditions were investigated and correlated with the precipitate magneto-optical properties.

Silicon Quantum Dots in Silica

Silicon ions were implanted into fused silica substrates at doses of 1×1021, 2×1021, 5×1021, and 1×1022 ions/cm3. The implanted substrates were annealed at 1100°C for one hour in a reducing atmosphere (95% Ar+5% H2). Optical absorption spectra recorded after the annealing treatment showed absorption onsets at 3.86, 3.73, 2.86 and 2.52 eV for substrates implanted with 1×1021, 2×1021, 5×1021, and 1×1022 ions/cm3, respectively. Static photoluminescence (PL) measurements indicated red emission between 1.72 and 1.61 nm with a slightly increasing red shift with ion dose. Time resolved PL at room temperature revealed slow (∼50 μs) and fast (×20 μs) lifetimes which increased with decreasing temperature. TEM studies showed that the particle size increased with increasing ion dose. Typical particle sizes ranged between 2 and 5 nm indicating quantum confinement of the exciton, which can account for the blue shift in the absorption edge with decreasing ion dose. However, the maxima in the PL spectra for all ion doses are relatively independent of the ion dose and are strongly shifted from the absorption spectra. This suggests that radiative recombination occurs from a common luminescent center, possibly a surface or interfacial state in thexs SiOx, layer surrounding the nanocrystal.

A new approach to the fabrication of “smart” near-surface nanostructure composites

A new method for the formation of “smart” near-surface nanoscale composites has been developed. In this approach, small precipitates of active phases are embedded in the near-surface region of the material that is to be modified by a combination of ion implantation and thermal processing. The dispersion, concentration, and microstructure of the nanocrystals formed in the substrate material can be tailored through a careful choice of processing parameters – making this approach well suited to high-value-added, high-technology applications. The applicability of this approach to forming “smart” surfaces on otherwise inactive materials was established in the case of VO2 precipitates which were embedded in A12O3 single crystals to create a medium suitable for optical applications – including optical data storage. Most recently, this concept has been extended to the fabrication of magnetic-field-sensitive nanostructured surfaces by forming magnetostrictive precipitates of materials such as Ni or RFe2 (with R = Tm, Tb, Sm) that are embedded in various single-crystal-oxide hosts. These nanostructured, active surface composites have been characterized using XRD, RBS, TEM, and magneto-optical techniques.

Optical Properties Of Si Nanocrystals Formed In Si02 By Ion Implantation

Si nanocrystals formed in SiO2 by high-dose ion implantation and annealing give rise to strong optical absorption and intense photoluminescence (PL). The dose dependence of optical absorption provides evidence for size-dependent quantum confinement in the Si nanocrystals. PL peak energies are nearly independent of dose suggesting that surface or interface states play an important role in PL. Estimates of absorption bandgaps in the nanocrystals are given.

Modification of ensemble emission rates and luminescence spectra for inhomogeneously broadened distributions of quantum dots coupled to optical microcavities

We investigate the spontaneous emission modifications when ensembles of quantum dots (QDs) with differing emission frequencies and finite Lorentzian linewidths are coupled to a microcavity. Using contour integrals we develop a general expression for the rate enhancement when neither the emitter nor the cavity resonance can be treated as a delta function. We show that the ensemble cavity-coupled luminescence lifetimes are generally suppressed in the case of spherical cavities and that the spontaneous emission dynamics of the cavity coupled component becomes increasingly stretched as the coupling factor increases. The Q-factor measured from the luminescence spectrum can be much lower than the intrinsic cavity Q-factor, and is in many practical situations limited by the QD spectral width. The mode spectrum observed in the photoluminescence (PL) spectrum can be largely determined by the QD emission linewidth, permitting this parameter to be extracted without requiring single-particle spectroscopy. In the case of Si-QDs, the linewidth cannot be significantly greater than 10 meV in order to observe spherical cavity resonances in the PL spectrum.

Silicon nanocrystals on bottle resonators: mode structure, loss mechanisms and emission dynamics

Bottle resonators can support high Q-factor whispering gallery modes (WGMs) and demonstrate a rich mode spectrum. Resonators were fabricated using a fiber tapering apparatus and were coated with a thin, smooth layer of luminescent silicon nanocrystals. The photoluminescence spectrum showed WGM peaks with Q-factors near 2,500; however, evanescent measurements showed that these modes are a composite of many modes with Q-factors exceeding 106, the highest yet seen for a silicon-nanocrystalcoated microresonators. The mode structure showed strong polarization and sensitivity to position within the bottle resonator. An analysis of loss mechanisms establishes surface roughness scattering as the limiting factor in these nanocrystal-coated bottle resonators in the absence of excited carriers.

The working practices and career satisfaction of dental therapists in New Zealand

OBJECTIVE

To describe the working practices and level of career satisfaction of dental therapists in New Zealand.

DESIGN

Postal survey of dental therapists identified from the New Zealand Dental Council's dental therapy database. One mailing with one follow-up.

PARTICIPANTS

Questionnaires were sent to 683 registered dental therapists. Replies were received from 566 (82.9%).

OUTCOME MEASURES

Current working practice, career breaks, continuing education, career satisfaction.

RESULTS

Respondents had a high career satisfaction, but were much less satisfied with their remuneration. After controlling for age and income satisfaction, therapists who felt that they were valued members of the dental community had over four times the odds of having higher overall job satisfaction. There were no differences in the mean career satisfaction scale score by age, but respondents aged 45 and over had a lower mean income satisfaction scale score than their younger counterparts (p<0.05). Older respondents were more likely to report regularly placing fissure sealants (p<0.05), participating in peer review (p<0.05), and playing a role in team management/coordination (p<0.05) than younger respondents. Most therapists (412; 82.2%) had taken at least one career break, usually for child rearing. A mean of 6.5 years (SD 5.9; range six weeks to 25 years) had been taken in career breaks. Younger therapists were more interested in moving into private practice than their older colleagues (p<0.05). More than half of respondents planned to retire from dental therapy within 10 years.

CONCLUSION

Urgent action is required to improve the recruitment and retention of dental therapists in the New Zealand School Dental Service. Measures to reduce the time taken in career breaks could increase the productivity of this workforce. Remuneration and career progression are key issues; therapists need to feel that they are valued members of the dental profession.

Nanocluster sensitized erbium-doped silicon monoxide waveguides

We describe the fabrication and characterization of micron-scale buried strip waveguides with erbium-doped (~ 1 at. %) silicon monoxide (SiO) cores and SiO(2) and polymer claddings. In spite of large core-cladding index offset (Deltan~0.4), propagation loss is as low as ~ 1 dB/cm. The cross-section for the (4)I(13/2) to (4)I(15/2) erbium transition was estimated as ~10(-20) cm(2), a factor of 2 to 3 higher than in silica glass. The annealed core material contains a high density of amorphous silicon nanoclusters, which act as efficient broadband sensitizers for erbium. Both a traditional co-propagating pump (980 nm wavelength) configuration and a transverse pump (532 nm wavelength, < 10 W/cm(2)) configuration were tested. In either case, free carrier absorption loss is the dominant pump-induced mechanism and approximately 15-20 % of the erbium population is invertible.

Frontal-striatal disconnection disrupts cognitive performance of the frontal-type in the rat

The prefrontal cortex is considered to provide executive control of response selection and planning in diverse cognitive tasks, translated into action via descending subcortical projections (or 'loops') through the basal ganglia. We have used a disconnection strategy to demonstrate first that bilateral fronto-striatal disconnection disrupts rats' abilities to perform delayed alternation, the classic test of prefrontal function in rats and monkeys, and second that crossed unilateral cortical and striatal lesions on opposite sides similarly disrupt rats' abilities to perform the same cognitive task. We found that effective disconnection requires interruption of interhemispheric transfer, achieved by transection of the anterior corpus callosum. This produces a moderate deficit in its own right, which is not exacerbated by additional prefrontal and striatal lesions in one hemisphere. Conversely, the animals are significantly more impaired after crossed prefrontal and striatal lesions of similar total magnitude. The results demonstrate than an intact cortico-striatal pathway is necessary to sustain performance on a classical prefrontal task, and provide a model within which to assess circuit reconstruction with novel cell therapies for brain repair.

Nanocrystalline zirconia can be amorphized by ion irradiation

Nanocrystalline composites are finding applications in high-radiation environments due to their excellent mechanical and electronic properties. We show, however, that at the smallest particle sizes, radiation damage effects can be so strongly enhanced that under the right conditions, materials that have never been made amorphous can become highly susceptible to irradiation-induced amorphization. Because light-weight, high-strength nanocomposites are potential materials for spacecraft shielding and sensor systems, these fundamental results have significant implications for the design and selection of materials to be used in environments where a large ion flux will be encountered.

Differential effects of unilateral striatal and nigrostriatal lesions on grip strength, skilled paw reaching and drug-induced rotation in the rat

Lateralised motor deficits associated with basal ganglia dysfunction were compared in separate groups of rats receiving unilateral 6-hydroxydopamine-induced lesions of the dopaminergic nigrostriatal pathway, quinolinic acid-induced lesions of the striatum, or sham control injections. Amphetamine induced ipsilateral rotation in both lesion groups, whereas a low ('supersensitive') dose of apomorphine induced rotation only in the nigrostriatal lesion group. Both lesions induced impairments in skilled paw reaching with the contralateral paw in the 'staircase' test; by contrast the striatal lesions also induced a marked impairment with the ipsilateral paw, which was unaffected by the nigrostriatal lesion. A previously reported increase in grip strength with the contralateral paw after nigrostriatal lesion was replicated, whereas striatal lesions induced only minor bilateral deficits in this test. The results are discussed in the context of the utility, reliability and validity of alternative tests of motor deficit in animal models of Parkinson's and Huntington's diseases.

Role of corticostriatal and nigrostriatal inputs in malonate-induced striatal toxicity

The striatal neuronal loss evident following cellular metabolic compromise may be dependent upon the presence of glutamate and dopamine within the striatum. In order to investigate the relative roles of corticostriatal and nigrostriatal projections in malonate-induced neuronal loss, the extent of toxicity was quantified in animals with cortical lesions to deplete the striatum of glutamate, nigrostriatal lesions to deplete the striatum of dopamine, or both. We found that malonate-induced striatal toxicity was significantly reduced following lesions of either the glutamatergic or dopaminergic afferents to the striatum. The extent of attenuation following the loss of both inputs within the same animal was similar to that seen following lesions of either alone. These data suggest that malonate-induced toxicity in the striatum depends upon the integrity of interactive influences from both glutamatergic and dopaminergic afferents.

The staircase test of skilled reaching in mice

The "staircase" test has become established for measurement of side-specific deficits in coordinated paw reaching in rats, and has been shown to reveal impairments on the contralateral side following unilateral lesions in a wide range of motor structures of the brain. As mice become more widely used in behavioural neuroscience, we have scaled down the staircase reaching test for application to this latter species. We here validate the test in C57BL/6J mice by (a) establishing the optimal dimensions of the apparatus, (b) comparing the effects of test parameters including sex, test duration, levels of deprivation and alternative reward pellets, and (c) demonstrating contralateral deficits after aspirative lesions of the motor cortex. Differences between mice and rats in normal performance of the task are noted. The staircase test provides a simple objective test of skilled motor function that allows measurement of lateralised effects without unduly constraining the animal, and which may prove as useful for mice as has previously been demonstrated in rats.

Age-dependence of malonate-induced striatal toxicity

Malonate is an inhibitor of cellular metabolism, which, following intrastriatal injection, induces a striatal pathology similar to that seen in Huntington's disease. In two parallel studies, we have investigated the suggested relationship between the neuronal vulnerability to metabolic toxicity and the decline in metabolic function with increasing age. The first experiment investigated malonate-induced neuronal loss in animals aged from 6 weeks up to 27 months, and the second assessed the activities of two mitochondrial enzymes, succinate dehydrogenase and cytochrome oxidase (CYTOX) in animals aged 6 weeks, 3, 8 and 18 months. In the first study, male Lister-Hooded rats received intrastriatal stereotaxic injections of malonate (0.5 or 1.0 M). Animals were killed 10 days after surgery, and the brains were stained with cresyl violet and processed for NADPH-diaphorase activity and glial fibrillary-acidic-protein (GFAP) immunohistochemistry. Animals aged 6 months and older exhibited over 60% striatal neuronal loss. However, the degree of neuronal loss did not show any age-related increase in rats between 6 and 27 months of age, indicating that the extent of malonate-induced toxicity does not increase with age in animals older than 6 months. Infusion of 0.5 M malonate produced smaller lesions, which also demonstrated a consistent extent of neuronal loss from 6 months onwards. Metabolic enzyme activities were decreased in the striatum with increasing age, although this effect was only significant for CYTOX activity. Thus, the pattern of malonate-induced neuronal loss in aged animals partially reflects the changes in metabolic activity during ageing.

5-Hydroxytryptamine (5-HT)4 receptors in post mortem human brain tissue: distribution, pharmacology and effects of neurodegenerative diseases

1. The distribution, pharmacology and effects of neurodegenerative diseases on 5-HT4 receptors in human brain have been characterized in vitro. 2. The 5-HT4 receptor in post mortem human brain tissue was specifically labelled with [3H]-GR 113808. In human putamen, this ligand labelled a homogeneous population of sites, with an apparent affinity (-log Kd) of 10.1 and a density (Bmax) of 5.73 fmol mg-1 tissue. The pharmacology of this site was characterized by use of a series of displacing ligands, and the following rank order of apparent affinities (with mean +/- s.d. -log Ki values in parentheses) was generated: GR113808 (10.05 +/- 0.04) > SDZ 205,557 (8.65 +/- 0.08) > DAU 6285 (7.95 +/- 0.04) > BIMU-1 (7.81 +/- 0.06) > DAU 6215 (7.42 +/- 0.23) > tropisetron (7.39 +/- 0.23) > 5-HT (7.32 +/- 1.00) > BIMU-8 (7.25 +/- 0.04) > (R)-zacopride (5.82 +/- 0.04). The Hill coefficients were not significantly different from unity, consistent with an interaction at a single site. A comparison of the affinities of these compounds with those obtained from guinea-pig striatum indicated no evidence of species differences. 3. The regional distribution of 5-HT4 receptors was assessed by determining the density of binding sites for [3H]-GR 113808. The distribution were as follows (with mean +/- s.d. Bmax values, fmol mg-1 tissue, in parentheses): caudate nucleus (8.7 +/- 1.5), lateral pallidum (8.6 +/- 5.5), putamen (5.7 +/- 3.0), medial pallidum (3.8 +/- 0.9), temporal cortex (2.6 +/- 0.6), hippocampus (2.4 +/- 0.8), amygdala (2.3 +/-1.1), frontal cortex (1.7 +/- 0.5), cerebellar cortex (<1.0). In these studies, the affinities of GR 113808 were not significantly different.4. The density of 5-HT4 receptors selected from regions of post mortem brains of patients with Parkinson's disease, Huntington's disease and Alzheimer's disease were compared to age-matched controls. In Parkinson's disease, there was no significant difference between control or patient values(mean +/- s.d. Bmax values, fmol mg-1 tissue; putamen, control 4.74 +/- 0.07, patient 5.86 +/- 1.48; substantia nigra, control 4.21 +/- 2.56, patient 5.57 +/- 0.10). In Huntington's disease, there was a significant decrease in putamen (control 5.33 +/- 1.08, patient 2.68 +/- 1.08), while in Alzheimer's disease, there was a marked loss of receptors in hippocampus (control 2.34 +/- 0.62, patient 0.78 +/- 0.61), in frontal cortex (control,1.76 +/- 0.19, patient 1.30 +/- 0.22). Receptor density in temporal cortex showed a decrease, but did not achieve statistical significance (control 2.06 +/- 0.21, patient 1.44 +/- 0.64).5. These data suggest a heterogeneous distribution of 5-HT4 receptors in human brain, with high to moderate densities in basal ganglia and limbic structures. These receptors may not be principally co-localized on dopaminergic cell bodies or terminals, given the lack of change observed in Parkinson's disease. The loss of 5-HT4 receptors in the putamen in Huntington's disease raises the possibility of their presence on intrinsic striatal GABAergic or cholinergic neurones. The marked loss of receptors in hippocampal and cortical regions in the brains from patients with Alzheimer's disease is consistent with a role for the 5-HT4 receptor in cognitive processing.

An investigation of the activities of 3-hydroxykynureninase and kynurenine aminotransferase in the brain in Huntington's disease

Previous reports have indicated abnormalities in the concentrations of metabolites of the tryptophan/kynurenine pathway in the brain in Huntington's disease. These have included an increase in 3-hydroxykynurenine and both increases and decreases in kynurenic acid. The activities of two enzymes involved in the metabolism of these compounds, 3-hydroxykynureninase and kynurenine aminotransferase, have been determined in post mortem brain tissue taken from Huntington's disease patients and control subjects.