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This study presents the Edinburgh Cognitive and Behavioural ALS Screen (ECAS), developed for ALS patients with physical disability for use by health care professionals. The screen is designed to detect the specific profile of cognition and behaviour changes in ALS and to differentiate it from other disorders. Forty-eight ALS patients (none with evident dementia), 40 healthy controls and 20 carers were recruited. The ECAS, a 15-20-min screen, includes an ALS-Specific score (executive functions and social cognition; fluency; language); an ALS Non-specific score (memory; visuospatial functions); and a carer behaviour screen of five domains characteristic of frontotemporal dementia (FTD). Data from healthy controls produced abnormality cut-offs of 77/100 ALS-Specific score; 24/36 ALS Non-specific score; 105/136 ECAS Total. Twenty-nine percent of patients showed abnormal ALS-Specific scores, and 6% also showed abnormal ALS Non-specific scores. The most prevalent deficit occurred in language functions (35%) followed by executive functions and fluency (23% each). Forty percent of carers reported behaviour change in at least one domain, while 15% met criteria for possible FTD. In conclusion, the ECAS is an effective within-clinic assessment for ALS that determines the presence, severity and type of cognitive and/or behavioural changes, an essential first step to managing these symptoms. [ABSTRACT FROM AUTHOR]

The ability to grow as a biofilm can facilitate survival of bacteria in the environment and promote infection. To better characterize biofilm formation in the pathogen Clostridium difficile, we established a colony biofilm culture method for this organism on a polycarbonate filter, and analyzed the matrix and the cells in biofilms from a variety of clinical isolates over several days of biofilm culture. We found that biofilms readily formed in all strains analyzed, and that spores were abundant within about 6 days. We also found that extracellular DNA (eDNA), polysaccharide and protein was readily detected in the matrix of all strains, including the major toxins A and/or B, in toxigenic strains. All the strains we analyzed formed spores. Apart from strains 630 and VPI10463, which sporulated in the biofilm at relatively low frequencies, the frequencies of biofilm sporulation varied between 46 and 65%, suggesting that variations in sporulation levels among strains is unlikely to be a major factor in variation in the severity of disease. Spores in biofilms also had reduced germination efficiency compared to spores obtained by a conventional sporulation protocol. Transmission electron microscopy revealed that in 3 day-old biofilms, the outermost structure of the spore is a lightly staining coat. However, after 6 days, material that resembles cell debris in the matrix surrounds the spore, and darkly staining granules are closely associated with the spores surface. In 14 day-old biofilms, relatively few spores are surrounded by the apparent cell debris, and the surface-associated granules are present at higher density at the coat surface. Finally, we showed that biofilm cells possess 100-fold greater resistance to the antibiotic metronidazole then do cells cultured in liquid media. Taken together, our data suggest that C. difficile cells and spores in biofilms have specialized properties that may facilitate infection. [ABSTRACT FROM AUTHOR]

Several studies have shown that people with Alzheimer's disease (AD) demonstrate difficulties in doing two things at once or 'dual-tasking' and that this dual task impairment is insensitive to normal ageing, chronic depression or prodromal conditions like Mild Cognitive Impairment. It is not known, however, if this impairment is specific to AD, or also present in other dementias, such as vascular dementia (VaD). In this study 15 people with VaD, 25 healthy age-matched and 25 healthy young controls were assessed using a paper and pencil dual tasking paradigm and several measures of working and episodic memory. Age had no effect on dual task performance, but the VaD patients demonstrated a significant impairment in dual tasking ability. Performance on the memory measures was instead affected by age with a further deterioration in the VaD patients. Both dual tasking and memory ability were significantly correlated with disease severity, as assessed by the MMSE. These results indicate that performance on the dual task could be a specific indicator of pathological ageing. [ABSTRACT FROM AUTHOR]

Objective: To determine baseline data in relation to the extraction of first permanent molar teeth during nitrous oxide/oxygen inhalation sedation sessions within the hospital dental service. Design: A prospective study. Setting: The Department of Paediatric Dentistry, Dundee Dental Hospital, NHS Tayside, UK. Method: Data were collected over a 12-month period for patients attending for the extraction of first permanent molar teeth using nitrous oxide/oxygen inhalation sedation. Results: Data were available for 133 patients (M: 68; F: 65) with a median age of 11.3 (inter-quartile range 10.0, 12.6) years. Over 80% of cases were treated using a mixture of 30% nitrous oxide and 70% oxygen, with a median sedation time of 30.0 (inter-quartile range 25.0, 40.0) minutes. Overall, 94.0% of cases successfully completed treatment and only 0.75% of cases failed to commence or complete treatment. Regarding each visit, 85.6% and 14.4% of patients underwent single- and multiple-tooth extractions respectively. There were no statistically significant differences between male and female patients, comparing both behaviour (Mann-Whitney U, W = 4,619.9, P = 0.750) and outcome scores (Mann-Whitney U, W = 4,392.5, P = 0.392). Conclusion: Extraction of first permanent molar teeth can be successfully achieved using nitrous oxide/oxygen inhalation sedation. [ABSTRACT FROM AUTHOR]

We have built and characterized the operation and performance of a surface plasmon resonance microscope that uses the rotation of an interference filter to vary the imaging wavelength of the system. The operation of the microscope with respect to signal processing, the dynamic range, and the limit of detection of the system, are described. [ABSTRACT FROM AUTHOR]

The correction notice for the article "A qualitative study exploring the clinical phenomenology and impact of hypersexuality in patients with Parkinson's Disease" addresses an omitted reference to a questionnaire for impulsive-compulsive disorders in Parkinson's Disease. The correction updates the prevalence figures for hypersexuality in Parkinson's Disease and renumbers the references accordingly. The original article has been corrected by the authors. [Extracted from the article]

The frontal lobes are thought to make a fundamental contribution to fluid intelligence. However, evidence that fluid intelligence is impaired following focal frontal lobe lesions is surprisingly sparse and based on non-verbal tests of fluid intelligence. We investigated performance on Part 1 of the Alice Heim 4 (AH4–1), a verbal test of fluid intelligence, in a sample of 35 patients with focal, unilateral, left or right, frontal brain tumours and 54 healthy controls. We analysed the following variables: overall number of correct AH4–1 answers, overall AH4–1 accuracy and accuracy on four selected categories of AH4–1 questions that assess abilities previously linked to the frontal lobes, namely: synonyms, verbal analogies, numerical series and multistage calculations. We found several significant frontal effects. Thus, in comparison to healthy controls, frontal patients had a significantly lower overall number of AH4–1 answers, had significantly lower overall AH4–1 accuracy and had significantly poorer performance on verbal analogies and multistage calculations. We also found several significant lateralised left frontal effects. Thus, in comparison to healthy controls, left, but not right, frontal patents had significantly lower overall AH4–1 accuracy and poorer performance on synonyms, numerical series and multistage calculation questions. This suggests that the left frontal lobe plays a critical role in AH4–1 performance. Moreover, left frontal patients had significantly lower overall AH4–1 accuracy and poorer performance on multistage calculations than right frontal patients. These results suggest that a left lateralised frontal network is critically involved in some aspects of fluid intelligence and, in particular, multistage calculations. • Previous lesion studies have used non-verbal tests of fluid intelligence. • First investigation of part 1 of the Alice Heim 4 (AH4–1) in frontal patients. • Overall AH4–1 accuracy specifically impaired in left frontal patients. • Left vs. right frontal patients impaired on multistage calculation questions. [ABSTRACT FROM AUTHOR]

Progressive supranuclear palsy (PSP) can be difficult to distinguish from Parkinson's disease (PD), but has a much graver prognosis. PSP is characterised severely reduced output on measures of phonemic fluency, suggesting that it may be a specific marker of PSP. However, reduced phonemic fluency has also been noted in PD, and very few studies have actually compared phonemic fluency in PSP and PD. Although anecdotal reports suggest that phonemic fluency output in PSP may have specific characteristics, with more low-frequency words and perseverative errors, no study to date has formally explored this. Further investigation into phonemic fluency output and its cognitive and neuroanatomical correlates is now critical for improving our understanding of the verbal fluency in PSP. In this study, we compared phonemic fluency characteristics (including quantity, frequency and error rates) in patients with PSP, PD and focal frontal or subcortical lesions, and age- and education-matched healthy controls. We then compared these characteristics with performance on extensive neuropsychological testing. We found that PSP patients generated significantly fewer words than patients with PD and patients with right frontal focal lesions, and healthy controls. Phonemic fluency was also significantly reduced in patients with left frontal and subcortical focal lesions. However, there were no significant group differences in word frequency or error rates. Phonemic fluency was best predicted by performance on the Vocabulary and Hayling neuropsychological tests. We argue that these findings provide important evidence that reduced phonemic fluency is a hallmark of PSP and argue that the specificity of this impairment betrays an underlying impairment in energization, reflecting dysfunction of left frontal and subcortical networks. • Reduced phonemic fluency is the neuropsychological hallmark of PSP. • This reflects underlying impairment in energization. • Phonemic fluency is subserved by left frontal and subcortical networks. [ABSTRACT FROM AUTHOR]

Rocky mountain spotted fever (RMSF) causes significant illness and death in children. Although historically rare in California, USA, RMSF is endemic in areas of northern Mexico that border California. We describe 7 children with RMSF who were hospitalized at a tertiary pediatric referral center in California during 2017-2023. Five children had recent travel to Mexico with presumptive exposure, but 2 children did not report any travel outside of California. In all 7 patients, Rickettsia rickettsii DNA was detected by plasma microbial cell-free nextgeneration sequencing, which may be a useful diagnostic modality for RMSF, especially early in the course of illness, when standard diagnostic tests for RMSF are of limited sensitivity. A high index of suspicion and awareness of local epidemiologic trends remain most critical to recognizing the clinical syndrome of RMSF and initiating appropriate antimicrobial therapy in a timely fashion. [ABSTRACT FROM AUTHOR]

Surveys repeatedly suggest inadequate psychological support for people with Parkinson's disease (PD). However, absence of official service or workforce statistics obscures our understanding of current service provision. The aims of this study were to provide the first formal evaluation of UK PD psychological services and identify any development needs. An online survey was distributed to clinical psychologists who were members of relevant professional groups and/or working in neurology centres. A total of 45 clinical psychologists responded to the survey. Respondents saw a mean of 19 PD patients in a year with marked variation in numbers seen and services offered, particularly between the different nations. There was limited integration with the multidisciplinary team and inclusion of carers. This may reflect inadequacies in professional training and supervision, as well as a lack of funding. Improved clinical guidelines, enhanced professional training and a better network for clinical supervision are now critical. [ABSTRACT FROM AUTHOR]

Background: People with Parkinson's disease (PD) have an increased risk of dementia, yet patients and clinicians frequently avoid talking about it due to associated stigma, and the perception that "nothing can be done about it". However, open conversations about PD dementia may allow people with the condition to access treatment and support, and may increase participation in research aimed at understanding PD dementia. Objectives: To co‐produce information resources for patients and healthcare professionals to improve conversations about PD dementia. Methods: We worked with people with PD, engagement experts, artists, and a PD charity to open up these conversations. 34 participants (16 PD; 6 PD dementia; 1 Parkinsonism, 11 caregivers) attended creative workshops to examine fears about PD dementia and develop information resources. 25 PD experts contributed to the resources. Results: While most people with PD (70%) and caregivers (81%) shared worries about cognitive changes prior to the workshops, only 38% and 30%, respectively, had raised these concerns with a healthcare professional. 91% of people with PD and 73% of caregivers agreed that PD clinicians should ask about cognitive changes routinely through direct questions and perform cognitive tests at clinic appointments. We used insights from the creative workshops, and input from a network of PD experts to co‐develop two open‐access resources: one for people with PD and their families, and one for healthcare professionals. Conclusion: Using artistic and creative workshops, co‐learning and striving for diverse voices, we co‐produced relevant resources for a wider audience to improve conversations about PD dementia. [ABSTRACT FROM AUTHOR]

This retrospective study evaluates the clinical utility of CFPNGS in the diagnosis and management of pediatric meningitis. CFPNGS identified a causative pathogen in 36% of 28 subjects, compared to 50% for diverse conventional testing (57% combined). CFPNGS may be considered as an adjunct to standard testing. • Cell-free plasma next generation sequencing (CFPNGS) is a commercial test for broad pathogen testing. • CFPNGS has potential utility as an adjunct modality in the evaluation of meningitis. • CFPNGS identified a putative pathogen in 36% of pediatric patients evaluated for meningitis. [ABSTRACT FROM AUTHOR]