Mesoporous SnO2-MoO3 catalyst for diesel oxidative desulfurization: Impact of the SnO2/MoO3 ratio on catalytic efficiency.

Vehicular SOx emissions have a huge detrimental impact on public health, catalytic converters, and the environment. Developing strategies to remove sulfur from diesel and thus safeguard the above is imperative. A series of SnO2-MoO3 mixed oxides and mono oxides MoO3 and SnO2 were prepared by soft template method, calcined at 450 °C and successfully tested in model diesel oxidative desulfurisation (ODS). The impact of the SnO2/MoO3 mole ratio (hereinafter denoted as Sn/Mo) on catalytic efficiency was investigated, among other catalytic parameters. The obtained samples were analyzed using X-ray diffraction (XRD), Raman spectrocscopy, scanning electron microscopy (SEM), N2-physisorption and titration method for acidic properties. The study demonstrates that mixing SnO2 and MoO3 improves acidic sites, crystallinity, and morphological properties of pure SnO2. The addition of MoO3 increased oxygen vacancies and the surface area of SnO2. High acidic site densities of 49.3, 47.4, and 46.7 mEqg-1 were observed for the catalysts with 2:1, 1:1, and 1:2 Sn/Mo mole ratio, respectively. The catalytic efficiency increased with an increase in Sn content with the highest catalytic efficiency of 99.8% for the dibenzothiophene (DBT) oxidation achieved in 30 min for Sn/Mo (2:1) catalyst compared to 92 and 70% for Sn/Mo 1:1 and 1:2 catalysts, respectively. The rate constant for the reaction was 0.057 min-1, which is eight times that of MoO3; 0.007 min-1 and three times that of SnO2; 0.017 min-1. The ODS mechanism utilizing the SnO2-MoO3 catalyst was proposed. The prepared SnO2-MoO3 catalyst demonstrated a high potential for industrial desulfurisation applications.

Processing-properties-performance triad relationship in a Washingtonia robusta mesoporous carbon materials-based supercapacitor device.

Two-electrode electrochemical tests provide a close performance approximation to that of an actual supercapacitor device. This study presents mesoporous carbon materials successfully derived from Washingtonia robusta bark (Mexican fan palm) and their electrical performance in a 2-electrode supercapacitor device. The triad relationship among carbon materials "processing, properties, and performance" was comprehensively investigated. X-ray diffraction reveal that amorphousness increases with activating KOH ratio and decreases with both activation time and temperature. Raman spectroscopy shows an increase in structural defects and degree of graphitization with an increase in KOH ratio, temperature and time while transmission electron microscopy shows conversion of aggregated particles to materials with interconnected porosity and subsequent destruction of porosity with an increase in KOH ratio. A nitrogen-sorption study reveals varying trends between BET, micro and mesopore surface areas, however, pore size and volume and hysteresis loop size decreases with KOH ratio and temperature. Electrochemical studies on the other hand reveal that both the specific capacitance and charge-discharge time increase with KOH ratio, temperature and time while both charge transfer and Warburg resistances decrease and the phase angles increases towards the ideal -90° with an increase in KOH ratio, temperature and time. The device fabricated with the HHPB sample prepared at 700 °C, KOH ratio 3 for 60 min attained a specific capacitance of 179.3 and 169 F g-1 at a scan rate of 5 mV s-1 and current density of 0.5 A g-1, respectively, good cycling stability with 95% capacitance retention and 100% coulombic efficiency when cycled 5000 times at a current density of 2 A g-1. HHPB electrodes reveal perfect EDLC behavior with an energy density of 20 W h kg-1 and power density of 2000 W kg-1 when used in a symmetric coin supercapacitor cell with 6 M KOH solution. These findings show the potential of fan palm bark as electrode materials with good stability and high-rate capability for supercapacitor application.

Synthesis of bismuth oxyhalide (BiOBr zI (1- z)) solid solutions for photodegradation of methylene blue dye.

Background: The removal of textile wastes is a priority due to their mutagenic and carcinogenic properties.  In this study, bismuth oxyhalide was used in the removal of methylene blue (MB) which is a textile waste. The main objective of this study was to develop and investigate the applicability of a bismuth oxyhalide (BiOBr zI (1-z)) solid solutions in the photodegradation of MB under solar and ultraviolet (UV) light irradiation. Methods: Bismuth oxyhalide (BiOBr zI (1-z)) (0 ≤ z ≤ 1) materials were successfully prepared through the hydrothermal method. Brunauer-Emmett-Teller (BET), transmission electron microscope (TEM), X-ray diffractometer (XRD), and scanning electron microscope (SEM) were used to determine the surface area, microstructure, crystal structure, and morphology of the resultant products. The photocatalytic performance of BiOBr zI (1-z) materials was examined through methylene blue (MB) degradation under UV light and solar irradiation. Results: The XRD showed that BiOBr zI (1-z) materials crystallized into a tetragonal crystal structure with (102) peak slightly shifting to lower diffraction angle with an increase in the amount of iodide (I -). BiOBr 0.6I 0.4 materials showed a point of zero charge of 5.29 and presented the highest photocatalytic activity in the removal of MB with 99% and 88% efficiency under solar and UV irradiation, respectively. The kinetics studies of MB removal by BiOBr zI (1-z) materials showed that the degradation process followed nonlinear pseudo-first-order model indicating that the removal of MB depends on the population of the adsorption sites. Trapping experiments confirmed that photogenerated holes (h +) and superoxide radicals ( •O 2 -) are the key species responsible for the degradation of MB. Conclusions : This study shows that bismuth oxyhalide materials are very active in the degradation of methylene blue dye using sunlight and thus they have great potential in safeguarding public health and the environment from the dye's degradation standpoint. Moreover, the experimental results agree with nonlinear fitting.

Randomized trial of polychromatic blue-enriched light for circadian phase shifting, melatonin suppression, and alerting responses.

Wavelength comparisons have indicated that circadian phase-shifting and enhancement of subjective and EEG-correlates of alertness have a higher sensitivity to short wavelength visible light. The aim of the current study was to test whether polychromatic light enriched in the blue portion of the spectrum (17,000 K) has increased efficacy for melatonin suppression, circadian phase-shifting, and alertness as compared to an equal photon density exposure to a standard white polychromatic light (4000 K). Twenty healthy participants were studied in a time-free environment for 7 days. The protocol included two baseline days followed by a 26-h constant routine (CR1) to assess initial circadian phase. Following CR1, participants were exposed to a full-field fluorescent light (1 × 1014 photons/cm2/s, 4000 K or 17,000 K, n = 10/condition) for 6.5 h during the biological night. Following an 8 h recovery sleep, a second 30-h CR was performed. Melatonin suppression was assessed from the difference during the light exposure and the corresponding clock time 24 h earlier during CR1. Phase-shifts were calculated from the clock time difference in dim light melatonin onset time (DLMO) between CR1 and CR2. Blue-enriched light caused significantly greater suppression of melatonin than standard light ((mean ±â€¯SD) 70.9 ±â€¯19.6% and 42.8 ±â€¯29.1%, respectively, p < 0.05). There was no significant difference in the magnitude of phase delay shifts. Blue-enriched light significantly improved subjective alertness (p < 0.05) but no differences were found for objective alertness. These data contribute to the optimization of the short wavelength-enriched spectra and intensities needed for circadian, neuroendocrine and neurobehavioral regulation.

The precipitation, growth and stability of mercury sulfide nanoparticles formed in the presence of marine dissolved organic matter.

The methylation of mercury is known to depend on the chemical forms of mercury (Hg) present in the environment and the methylating bacterial activity. In sulfidic sediments, under conditions of supersaturation with respect to metacinnabar, recent research has shown that mercury precipitates as ß-HgS(s) nanoparticles (ß-HgS(s)nano). Few studies have examined the precipitation of ß-HgS(s)nano in the presence of marine dissolved organic matter (DOM). In this work, we used dynamic light scattering (DLS) coupled with UV-Vis spectroscopy and transmission electron microscopy (TEM) to investigate the formation and fate of ß-HgS(s)nano formed in association with marine DOM extracted from the east and west of Long Island Sound, and at the shelf break of the North Atlantic Ocean, as well as with low molecular weight thiols. We found that while the ß-HgS(s)nano formed in the presence of oceanic DOM doubled in size after 5 weeks, those forming in solutions with coastal DOM did not grow over time. In addition, when the HgII : DOM ratio was varied, ß-HgS(s)nano only rapidly aggregated at high ratios (>41 µmol HgII per mg C) where the concentration of thiol groups was determined to be substantially low relative to HgII. This suggests that functional groups other than thiols could be involved in the stabilization of ß-HgS(s)nano. Furthermore, we showed that ß-HgS(s)nano forming under anoxic conditions remained stable and could therefore persist in the environment sufficiently to impact the methylation potential. Exposure of ß-HgS(s)nano to sunlit and oxic environments, however, caused rapid aggregation and sedimentation of the nanoparticles, suggesting that photo-induced changes or oxidation of organic matter adsorbed on the surface of ß-HgS(s)nano affected their stability in surface waters.

A general approach to crystalline and monomodal pore size mesoporous materials.

Mesoporous oxides attract a great deal of interest in many fields, including energy, catalysis and separation, because of their tunable structural properties such as surface area, pore volume and size, and nanocrystalline walls. Here we report thermally stable, crystalline, thermally controlled monomodal pore size mesoporous materials. Generation of such materials involves the use of inverse micelles, elimination of solvent effects, minimizing the effect of water content and controlling the condensation of inorganic frameworks by NO(x) decomposition. Nanosize particles are formed in inverse micelles and are randomly packed to a mesoporous structure. The mesopores are created by interconnected intraparticle voids and can be tuned from 1.2 to 25 nm by controlling the nanoparticle size. Such phenomena allow the preparation of multiple phases of the same metal oxide and syntheses of materials having compositions throughout much of the periodic table, with different structures and thermal stabilities as high as 800 °C.

Interconnected carbon nanosheets derived from hemp for ultrafast supercapacitors with high energy.

We created unique interconnected partially graphitic carbon nanosheets (10-30 nm in thickness) with high specific surface area (up to 2287 m(2) g(-1)), significant volume fraction of mesoporosity (up to 58%), and good electrical conductivity (211-226 S m(-1)) from hemp bast fiber. The nanosheets are ideally suited for low (down to 0 °C) through high (100 °C) temperature ionic-liquid-based supercapacitor applications: At 0 °C and a current density of 10 A g(-1), the electrode maintains a remarkable capacitance of 106 F g(-1). At 20, 60, and 100 °C and an extreme current density of 100 A g(-1), there is excellent capacitance retention (72-92%) with the specific capacitances being 113, 144, and 142 F g(-1), respectively. These characteristics favorably place the materials on a Ragone chart providing among the best power-energy characteristics (on an active mass normalized basis) ever reported for an electrochemical capacitor: At a very high power density of 20 kW kg(-1) and 20, 60, and 100 °C, the energy densities are 19, 34, and 40 Wh kg(-1), respectively. Moreover the assembled supercapacitor device yields a maximum energy density of 12 Wh kg(-1), which is higher than that of commercially available supercapacitors. By taking advantage of the complex multilayered structure of a hemp bast fiber precursor, such exquisite carbons were able to be achieved by simple hydrothermal carbonization combined with activation. This novel precursor-synthesis route presents a great potential for facile large-scale production of high-performance carbons for a variety of diverse applications including energy storage.

Nano-size layered manganese-calcium oxide as an efficient and biomimetic catalyst for water oxidation under acidic conditions: comparable to platinum.

Inspired by Nature's catalyst, a nano-size layered manganese-calcium oxide showed a low overvoltage for water oxidation in acidic solutions, which is comparable to platinum.

Effects of visible and UV light on the characteristics and properties of crude oil-in-water (O/W) emulsions.

The effects of visible and UV light on the characteristics and properties of Prudhoe Bay (PB) and South Louisiana (SL) emulsions were investigated to better understand the role of sunlight on the fate of spilled crude oils that form emulsions with a dispersant in the aquatic environment. Before irradiation, crude oil emulsions showed the presence of dispersed crude oil micelles in a continuous water phase and crude oil components floating on the surface. The crude oil micelles decreased in size with irradiation, but emulsions retained their high degree of polydispersity. UV irradiation reduced the stability of emulsions more effectively than visible light. The reduction of micelles size caused the viscosity of emulsions to increase and melting point to decrease. Further, irradiation increased acid concentrations and induced ion formation which lowered the pH and increased the conductivity of emulsions, respectively. Ni and Fe in PB emulsions were extracted from crude oil with UV irradiation, which may provide an efficient process for metal removal. The emulsions were stable toward freeze/thaw cycles and their melting temperatures generally decreased with irradiation. Evidence of ˙OH production existed when emulsions were exposed to UV but not to visible light. The presence of H(2)O(2) enhanced the photodegradation of crude oil. Overall, the changes in emulsion properties were attributed to direct photodegradation and photooxidation of crude oil components.

Light-assisted synthesis of metal oxide hierarchical structures and their catalytic applications.

Short reaction times and morphology control in the synthesis of inorganic materials under nonthermal conditions remain a challenge. Herein we report a rapid, self-templating, and nonthermal method based on ultraviolet light to prepare metal oxide hierarchical structures. With this method, the morphology of the metal oxides was controlled readily without using templates.

Duffy (Fy), DARC, and neutropenia among women from the United States, Europe and the Caribbean.

Neutropenia associated with race/ethnicity has essentially been unexplained and, although thought to be benign, may affect therapy for cancer or other illnesses. A recent study linked a single nucleotide polymorphism (SNP) (rs2814778) in the Duffy antigen/receptor chemokine gene (DARC) with white blood cell count. We therefore analysed the association of the rs2814778 CC, TC and TT genotypes with absolute neutrophil count (ANC) among asymptomatic women from the Caribbean, Europe and the United States. Among 261 study participants, 33/47 women from Barbados/Trinidad-Tobago, 34/49 from Haiti, 26/37 from Jamaica, and 29/38 US-born black women, but only 4/50 from the Dominican Republic and 0/40 US- or European-born whites (P = 0.0001) had the CC genotype. In a linear regression model that included percentage African ancestry, national origin, cytokines, socio-economic factors and the ELA2 rs57834246 SNP, only the DARC rs2814778 genotype and C-reactive protein were associated with ANC (P < 0.0001). Women with the CC genotype had lower ANC than other women. Further research is needed on the associations of rs2814778 genotype with neutropenia and treatment delay in the setting of cancer. A better understanding of these associations may help to improve cancer outcomes among individuals of African ancestry.

Duffy (Fy), DARC, and neutropenia among women from the United States, Europe and the Caribbean.

Neutropenia associated with race/ethnicity has essentially been unexplained and, although thought to be benign, may affect therapy for cancer or other illnesses. A recent study linked a single nucleotide polymorphism (SNP) (rs2814778) in the Duffy antigen/receptor chemokine gene (DARC) with white blood cell count. We therefore analysed the association of the rs2814778 CC, TC and TT genotypes with absolute neutrophil count (ANC) among asymptomatic women from the Caribbean, Europe and the United States. Among 261 study participants, 33/47 women from Barbados/Trinidad-Tobago, 34/49 from Haiti, 26/37 from Jamaica, and 29/38 US-born black women, but only 4/50 from the Dominican Republic and 0/40 US- or European-born whites (P = 0.0001) had the CC genotype. In a linear regression model that included percentage African ancestry, national origin, cytokines, socio-economic factors and the ELA2 rs57834246 SNP, only the DARC rs2814778 genotype and C-reactive protein were associated with ANC (P < 0.0001). Women with the CC genotype had lower ANC than other women. Further research is needed on the associations of rs2814778 genotype with neutropenia and treatment delay in the setting of cancer. A better understanding of these associations may help to improve cancer outcomes among individuals of African ancestry.

Diffusion tensor MR imaging reveals persistent white matter alteration after traumatic brain injury experienced during early childhood.

BACKGROUND AND PURPOSE: Diffusion tensor imaging (DTI) can noninvasively quantify white matter (WM) integrity. Although its application in adult traumatic brain injury (TBI) is common, few studies in children have been reported. The purposes of this study were to examine the alteration of fractional anisotropy (FA) in children with TBI experienced during early childhood and to quantify the association between FA and injury severity. MATERIALS AND METHODS: FA was assessed in 9 children with TBI (age = 7.89 +/- 1.00 years; Glasgow Coma Scale [GCS] = 10.11 +/- 4.68) and a control group of 12 children with orthopedic injuries without central nervous system involvement (age = 7.51 +/- 0.95 years). All of the subjects were at minimum 12 months after injury. We examined group differences in a series of predetermined WM regions of interest with t test analysis. We subsequently conducted a voxel-wise comparison with Spearman partial correlation analysis. Correlations between FA and injury severity were also calculated on a voxel-wise basis. RESULTS: FA values were significantly reduced in the TBI group in genu of corpus callosum (CC), posterior limb of internal capsule (PLIC), superior longitudinal fasciculus (SLF), superior fronto-occipital fasciculus (SFO), and centrum semiovale (CS). GCS scores were positively correlated with FA in several WM areas including CC, PLIC, SLF, CS, SFO, and inferior fronto-occipital fasciculus (IFO). CONCLUSION: This DTI study provides evidence that WM integrity remains abnormal in children with moderate-to-severe TBI experienced during early childhood and that injury severity correlated strongly with FA.

Discrepancy between neuroimaging findings and clinical phenotype in Alexander disease.

We present a case of infantile-onset Alexander disease (AD) with a novel glial fibrillary acidic protein mutation but without clinical evidence of neurologic deterioration. Brain MRI studies showed typical AD findings and increasing size of frontal cavitations. Serial proton MR spectroscopy demonstrated high levels of myo-inositol and lactic acid and decreasing levels of N-acetylaspartate. The degree of demyelination and the timing of the axonal degeneration may determine phenotypic severity of the disease. Conventional neuroimaging techniques cannot always predict the outcome.

Brain MRI and proton MRS findings in infants and children with respiratory chain defects.

OBJECTIVE: The aim of this study is to describe neuroimaging patterns in children with respiratory chain (RC) defects using magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (MRS) and to assess their role in the diagnostic evaluation. METHOD: Neuroimaging studies of 49 children (newborn to 15 years old) with biochemical evidence of RC defect were reviewed. Patients were divided in 3 groups ("definite" = 24, "probable" = 14, "possible" = 11) according to Modified Adult Criteria for the diagnosis of RC defect. Eighty-one MRI studies were reviewed for deep gray and white matter changes, degree of myelination, cerebral and cerebellar atrophy, and 67 proton MRS studies were assessed for the presence or absence of lactate elevation, as well as NAA/Cr ratio. The findings were compared among the 3 groups with chi-square test. RESULTS: All patients with "pure" myopathy had normal imaging studies. In patients with CNS involvement, significant differences in the frequency of imaging abnormalities among groups were found for deep gray matter (43 %/8 %/0 %; p = 0.01) and for the presence of lactate elevation on proton MRS (81 %/31 %/0 %; p = 0.001). CONCLUSION: Brain MRI and proton MRS abnormalities were observed only in association with clinical CNS involvement. Deep gray matter signal abnormalities on structural imaging and lactate elevation on proton MRS were more frequently observed in the "definite" group and represent neuroimaging markers for RC mitochondriopathy.

Measuring drug concentrations using pulsatile microdialysis: theory and method development in vitro.

A novel method of rapidly sampling drug concentrations, based on pulsatile microdialysis (PMD), was developed. In PMD, a dialysate fluid is pumped into a microdialysis probe, allowed to occupy the probe while at rest for some time, and then flushed at a high rate. A model that is based on a Fick's Laws was solved and tested, using methazolamide (MTZ) as the test drug in a variety of experimental setups, including time-dependent donor concentrations. Calibration plots of the donor versus sample concentrations were linear. There was excellent agreement between the calculated and experimental values of the fraction recovered obtained from the calibration plots. In a system for which the donor concentration declined in a first order manner, the data obtained using PMD and direct sampling of the donor were in nearly exact agreement with the theoretical value of k=0.09 min(-1). PMD was also able to collect data points quickly enough to characterize the rapid binding kinetics of MTZ by activated charcoal. It was concluded that PMD is an accurate method of sampling drug concentrations, and can obtain samples over shorter time intervals and more frequently than previously available methods.

X-linked creatine transporter defect: an overview.

In 2001 we identified a new inborn error of metabolism caused by a defect in the X-linked creatine transporter SLC6A8 gene mapped at Xq28 (SLC6A8 deficiency, McKusick 300352). An X-linked creatine transporter defect was presumed because of (1) the absence of creatine in the brain as indicated by proton magnetic resonance spectroscopy (MRS); (2) the elevated creatine levels in urine and normal guanidinoacetate levels in plasma, ruling out a creatine biosynthesis defect; (3) the absence of an improvement on creatine supplementation; and (4) the fact that the pedigree suggested an X-linked disease. Our hypothesis was proved by the presence of a hemizygous nonsense mutation in the male index patient and by the impaired creatine uptake by cultured fibroblasts. Currently, at least 7 unrelated families (13 male patients and 13 carriers) with a SLC6A8 deficiency have been identified. Four families come from one metropolitan area. This suggests that SLC6A8 deficiency may have a relatively high incidence. The hallmarks of the disorder are X-linked mental retardation, expressive speech and language delay, epilepsy, developmental delay and autistic behaviour. In approximately 50% of the female carriers, learning disabilities of varying degrees have been noted.

Understanding and use of inhaler medication by asthmatics in specialty care in Trinidad: a study following development of Caribbean guidelines for asthma management and prevention.

STUDY OBJECTIVES: Following the development of the Caribbean Guidelines for Asthma Care, we examined the utilization of inhaled medications in asthmatic patients in Trinidad, West Indies. SETTING: Chest Clinic, Ministry of Health, Trinidad. PARTICIPANTS: Physician-diagnosed asthmatic patients who attended the Chest Clinic between July 1998 and August 2000. MEASUREMENTS AND RESULTS: A consecutive sample of patients who were > 7 years of age (n = 402) was interviewed about compliance with, understanding of, and use of inhaler medication. The inhaler technique of these patients was directly observed. Inhaled steroid therapy was prescribed in 83% of patients but were prescribed the least in elderly patients (63%) and children (62%). Salbutamol was prescribed in 98% of patients, and ipratropium and sodium cromoglycate were selectively prescribed in elderly men and children, respectively. Only 33% of patients used the inhaler correctly, and children and the elderly were the least efficient in its use. The use of a spacer device was advised in 19% of patients, including only 6% of the elderly patients. Explanations for different inhaler therapies were given to 62% of patients, and 53% of patients could describe these reasons. The reported 40% noncompliance rate among patients in the sample was primarily a result of long waiting periods at the pharmacy (58%) and the personal cost incurred on purchasing the medication (52%). CONCLUSIONS: Educating patients, with a focus on children and the elderly, in inhaler techniques and reinforcing understanding of asthma medications can improve asthma management in Trinidad. Asthma caregivers in the Caribbean should ensure the appropriate dissemination of the guidelines and should outline strategies for their implementation.

Understanding and use of inhaler medication by asthmatics in specialty care in Trinidad: a study following development of Caribbean guidelines for asthma management and prevention

STUDY OBJECTIVES: Following the development of the Caribbean Guidelines for Asthma Care, we examined the utilization of inhaled medications in asthmatic patients in Trinidad, West Indies. SETTING: Chest Clinic, Ministry of Health, Trinidad. PARTICIPANTS: Physician-diagnosed asthmatic patients who attended the Chest Clinic between July 1998 and August 2000. MEASUREMENTS AND RESULTS: A consecutive sample of patients who were > 7 years of age (n = 402) was interviewed about compliance with, understanding of, and use of inhaler medication. The inhaler technique of these patients was directly observed. Inhaled steroid therapy was prescribed in 83% of patients but were prescribed the least in elderly patients (63%) and children (62%). Salbutamol was prescribed in 98% of patients, and ipratropium and sodium cromoglycate were selectively prescribed in elderly men and children, respectively. Only 33% of patients used the inhaler correctly, and children and the elderly were the least efficient in its use. The use of a spacer device was advised in 19% of patients, including only 6% of the elderly patients. Explanations for different inhaler therapies were given to 62% of patients, and 53% of patients could describe these reasons. The reported 40% noncompliance rate among patients in the sample was primarily a result of long waiting periods at the pharmacy (58%) and the personal cost incurred on purchasing the medication (52%). CONCLUSIONS: Educating patients, with a focus on children and the elderly, in inhaler techniques and reinforcing understanding of asthma medications can improve asthma management in Trinidad. Asthma caregivers in the Caribbean should ensure the appropriate dissemination of the guidelines and should outline strategies for their implementation.

Congenital creatine transporter deficiency.

BACKGROUND: Two inborn errors of metabolism of creatine synthesis as well as the X-linked creatine transporter (SLC6A8) deficiency have been recognized. This report describes the features of five identified male patients and their female relatives who are carriers of the X-linked creatine transporter deficiency syndrome. METHODS: Proton MR spectroscopy was used to recognize creatine deficiency in the patients. Molecular analysis of the SLC6A8 gene was performed, confirming the diagnosis of homozygous males and heterozygous females. RESULTS: We describe four families from a metropolitan area in the U. S. with X-linked creatine transporter deficiency. All affected males present with developmental delay and severe developmental language impairment. Proton MR spectroscopy shows significantly depressed to essentially absent creatine and phosphocreatine in the male patients. Nonsense mutations and amino acid deletions were found in the SLC6A8 gene in the affected families. CONCLUSION: Creatine transporter deficiency may be a more common X-linked genetic disorder than originally presumed. The affected males exhibit mental retardation with severe expressive language impairment.