Older adults experience difficulty completing the lines and dots tasks of the Motor Assessment Scale.

BACKGROUND: The advanced hand activities item of the Motor Assessment Scale (Upper Limb items, UL-MAS) includes the 'lines' and 'dots' tasks, which require skilful pencil use. Prior Rasch analysis studies identify these two tasks as the most difficult to achieve for stroke survivors compared with the other advanced hand activities. Yet it is unknown if healthy, older adults can perform these two tasks. OBJECTIVES: To describe the performance of older adults' without stroke on the 'lines' and 'dots' tasks, relationship between age and task performance, and relationship between writing speed and performance on the 'lines' task. METHODS: Cross-sectional study design. A sample of healthy older Australians (n = 120) aged between 60 and 99 years completed the UL-MAS 'lines' and 'dots' tasks and wrote two sentences using pencil. RESULTS: Fifty-four participants (45%) failed the UL-MAS 'lines' task. Differences in line drawing performance across age groups were statistically significant (chi-square = 9.02, df = 3, p = .03). Eleven participants (9%) failed the 'dots' task, mostly from the 90 to 99 year age group. Participants who passed the 'lines' task wrote sentences faster than participants who failed (p<.001). CONCLUSION: Older adults may not pass the UL-MAS 'lines' and 'dots' tasks due to age and individual skill level.

Examining the species-specificity of rhesus macaque cytomegalovirus (RhCMV) in cynomolgus macaques.

Cytomegalovirus (CMV) is a highly species-specific virus that has co-evolved with its host over millions of years and thus restricting cross-species infection. To examine the extent to which host restriction may prevent cross-species research between closely related non-human primates, we evaluated experimental infection of cynomolgus macaques with a recombinant rhesus macaque-derived CMV (RhCMV-eGFP). Twelve cynomolgus macaques were randomly allocated to three groups: one experimental group (RhCMV-eGFP) and two control groups (UV-inactivated RhCMV-eGFP or media alone). The animals were given two subcutaneous inoculations at week 0 and week 8, and a subset of animals received an intravenous inoculation at week 23. No overt clinical or haematological changes were observed and PBMCs isolated from RhCMV-eGFP inoculated animals had comparable eGFP- and IE-1-specific cellular responses to the control animals. Following inoculation with RhCMV-eGFP, we were unable to detect evidence of infection in any blood or tissue samples up to 4 years post-inoculation, using sensitive viral co-culture, qPCR, and Western blot assays. Co-culture of urine and saliva samples demonstrated the presence of endogenous cynomolgus CMV (CyCMV) cytopathic effect, however no concomitant eGFP expression was observed. The absence of detectable RhCMV-eGFP suggests that the CyCMV-seropositive cynomolgus macaques were not productively infected with RhCMV-eGFP under these inoculation conditions. In a continued effort to develop CMV as a viral vector for an HIV/SIV vaccine, these studies demonstrate that CMV is highly restricted to its host species and can be highly affected by laboratory cell culture. Consideration of the differences between lab-adapted and primary viruses with respect to species range and cell tropism should be a priority in evaluating CMV as vaccine vector for HIV or other pathogens at the preclinical development stage.

Whole blood versus plasma spots for measurement of HIV-1 viral load in HIV-infected African patients.

The increasing availability of antiretroviral drugs to HIV-infected populations in developing countries highlights the need to develop field-friendly practical methods for HIV-1 viral load measurements to monitor the effects of treatment. We compared use of whole-blood spots versus plasma dried on filter paper to quantify HIV-1 viral load in 51 African patients with HIV-1. The mean log10 HIV-1 viral loads were 4.22 for dried plasma spots (DPS) and 4.20 for dried whole-blood spots (DBS). The difference between the pairs of log10 viral load for DPS and DBS were significantly correlated with their mean (Spearman's r=0.31, p=0.03). This correlation between the difference and mean of viral load was no longer evident for values of log10 DPS that were less than 5 (r=0.01, p=0.93). For the 38 paired values with log10DPS of less than 5, the mean difference (log10DPS-log10DBS) was -0.04 (SD 0.29). Dried whole blood stored on filter paper at room temperature shows potential as a field-friendly alternative to plasma for measurement of HIV-1 viral load.

Use of dried whole blood spots to measure CD4+ lymphocyte counts in HIV-1-infected patients.

As antiretroviral drugs become widely available in developing countries, practical, field-friendly, and cheap methods of measuring CD4+ lymphocyte counts need to be developed. We tested use of whole blood spots dried on filter paper to measure CD4+ lymphocyte counts. We obtained blood from 42 HIV-1-infected patients from Zambia. We dried blood spots on filter paper and measured CD4+ lymphocyte counts with an established commercial enzyme immunoassay. We compared these measurements with those obtained from matched liquid whole-blood samples analysed with standard flow cytometry. Results of the filter-paper method accorded well with flow cytometry CD4 counts greater than 200 cells/microL (mean difference 13.6 [SD 52.4]). Dried whole blood stored on filter paper could be developed into a field-friendly alternative for CD4+ lymphocyte count measurements.

The risk of human immunodeficiency virus-1 infection in twin pairs born to infected mothers in Africa.

We examined birth order and delivery route as risk factors for mother-to-child transmission of human immunodeficiency virus (HIV)-1 in 315 twin pairs born in Malawi during 1994-1998. No antiretroviral drugs were administered to these subjects. Infections were detected by polymerase chain reaction and were stratified as having occurred either in utero, perinatally, or postnatally. Risk of in utero infection for 630 infants (39 infections) did not differ by birth order (first born, 6.3%; second born, 6.0%). Similarly, in 260 vaginally delivered infants evaluated for perinatal infection (45 infections), risk did not differ by birth order (first born, 15.9%; second born, 18.7%); risk of perinatal infection was significantly lower in cesarean-delivered infants (odds ratio, 0.19 [95% confidence interval, 0.02-0.78]). There was no effect on postnatal transmission rates. Thus, in contrast to the authors of earlier studies, we did not find birth order to be an important risk factor for infection in twins. These findings indicate that birth-canal exposure is not a major contributor to a newborn's risk of HIV-1 infection.

Human immunodeficiency virus type 1 infection in twin pairs infected at birth.

Host genetic factors may influence the course of human immunodeficiency virus (HIV) infection. In Blantyre, Malawi, polymerase chain reaction was used to identify twin pairs who were concordantly HIV-1-infected in utero or perinatally and then to examine strain divergence or virus levels in identical and fraternal twin pairs. Among 315 twin pairs, both infants in 14 fraternal and 5 identical pairs were found to be infected at the same visit. Among 10 pairs, HIV-1 sequences were determined for both infants at >or=1 time point. HIV levels had a common profile in both fraternal and identical twin pairs. Identical twins were not always infected by the same quasi species, indicating that their mothers had multiple quasi species capable of infecting their infants. Subsequent viral divergence appears to depend on quasi-species stability rather than on genetically controlled host immune responses. Thus, given infection, factors intrinsic to HIV-1 are more important than host genetics in viral evolution.