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Report of an ISRTP workshop: progress and barriers to incorporating alternative toxicological methods in the U.S.

The workshop objectives were to explore progress in implementing new, revised and alternative toxicological test methods across regulatory evaluation frameworks and decision-making programs in the United States, to identify barriers and to develop recommendations to further promote adoption of approaches that reduce, refine, or replace the use of animal methods. The workshop included sessions on: (1) current research, development, and validation of alternative methods within the U.S. federal government; (2) emerging alternative methodologies with potential applications to a broad spectrum of toxicity evaluation strategies; (3) tiered evaluation ("intelligent testing") strategies; and (4) identification of, and recommendations to address, critical barriers that affect adoption and use of new, revised alternative toxicological test methods by U.S. regulatory agencies. Through facilitated discussion, a list of barriers and recommendations were developed and grouped into categories of economic/financial, scientific/technical, and regulatory/policy. Overall, participants from all sectors collectively supported catalyzing actions to promote more meaningful and rapid progress for research to develop alternative methods focused for use in regulatory programs, accelerated lab investigations to validate such alternative methods and adoption of regulatory frameworks which embrace and incorporate these validated alternatives.

Animal Testing Alternatives↗

[New articulation lists for speech audiometry. Part I].

Ten articulation lists for speech intelligibility testing and evaluation of hearing impairment type have been constructed. Each list contains 24 from among the most frequent monosyllabic Polish nouns. The lists are balanced phonemically, semantically, acoustically and structurally.

Audiometry, Speech↗

Functional role of the human inferior colliculus in binaural hearing.

Psychophysical experiments were carried out in a rare case involving a 48 year old man (RJC) with a small traumatic hemorrhage of the right dorsal midbrain, including the inferior colliculus (IC). RJC had normal audiograms bilaterally, but there was a marked decrease in wave V amplitude on click-evoked brainstem auditory evoked potentials following left ear stimulation. RJC demonstrated a deficit in sound localization identification when the loudspeakers lay within the auditory hemifield contralateral to his IC lesion. Errors showed a consistent bias towards the hemifield ipsilateral to the lesion. Echo suppression was abnormally weak compared with that seen in control subjects, but only for sources contralateral to the lesion. Finally, speech intelligibility tests showed normal ability to benefit from spatial separation of target and competing speech sources. These results suggest that: (1) localizing sounds within a given hemifield relies on the integrity of the contralateral IC, (2) unilateral IC lesions give the illusion that sound sources in the 'bad' hemifield are displaced towards the 'good' hemifield, (3) the IC mediates aspects of echo suppression, and (4) lesion in the IC does not impede spatial release from masking in speech intelligibility, possibly due to that ability being more heavily mediated by cortical regions.

Acoustic Stimulation↗

The fragile X syndrome in a large family. II. Psychological investigations.

Intelligence levels and intelligence profiles were investigated in 52 members of a large family with the fragile X syndrome. The mental abilities were evaluated by the three Wechsler intelligence tests (WAIS, WISC-R, and WPPSI). Chromosomal and psychological data were then compared. In 22 non-retarded fra(X) negative family members, a mean IQ of 102 was found (males 97, females 106). Eleven non-retarded carrier females had IQs between 70 and 110 (mean 86.8), which is 20 points below the mean of normal women (alpha = 0.01). One non-retarded male with 6% fra(X) positive cells had an IQ of 98. His intelligence profile closely resembled the profile in the non-retarded female carriers. The highest IQ in the group of retarded males was 31. The mentally retarded females scored IQs between 26 and 41. In male and female patients verbal intelligence substantially exceeded performance abilities. There was a considerable gap between the highest IQ in the group of retarded females and the lowest IQ in the group of non-retarded carriers (41 and 71 respectively) and a considerable overlap was found between the IQ levels of the non-retarded carriers and normal women.

Female↗

Neurobehavioral testing of subjects exposed residentially to groundwater contaminated from an aluminum die-casting plant and local referents.

Residents adjoining a die-casting plant had excessive headaches, numbness of hands and feet, dizziness, blurred vision, staggering, sweating, abnormal heart rhythm, and depression, which led to measurements of neurobehavioral performance, affective status, and the frequency of symptoms. They had all been exposed via well water and proximity to the plant to volatile organic chemicals (VOC) and to polychlorinated biphenyls (PCBs). The 117 exposed women and men and 46 unexposed referents were studied together for simple and choice visual reaction time, body sway speed, blink reflex latency, color discrimination, Culture Fair (a nonverbal nonarithmetic intelligence test), recall of stories, figures, and numbers, cognitive and psychomotor control (slotted pegboard and trail making A and B), long-term memory, profile of mood states (POMS), and scores and frequencies of 34 symptoms. Choice reaction time, sway speed, and blink latency were impaired in both sexes of the exposed group and trail making B was impaired in exposed women. The POMS scores and frequencies of 30 of 34 symptoms were elevated in both sexes, compared to referents. Recall, long-term memory, psychomotor speed, and other cognitive function tests were reduced in exposed subjects and in the referents as compared to national referents. Neurophysiological impairment, and cognitive and psychomotor dysfunction and affective disorders, especially depression and excessive frequency of symptoms, were associated with the use of wells contaminated with VOCs, TCE and PCBs.

Adolescent↗

Blood phenylalanine levels and intelligence of 10-year-old children with PKU in the National Collaborative Study.

Dietary intakes and blood phenylalanine levels of 125 10-year-old children with PKU are reported. Of those patients, 59 discontinued the special diet at 6 years, 16 discontinued at 8 years, 5 discontinued at 6 years but returned to the diet at 8 1/2 years, and 45 continued the diet to 10 years. Phenylalanine intake was determined by 2-day diet records. Blood phenylalanine concentrations revealed a lack of clear distinction between the diet groups; therefore, regression analysis was performed on the group as a whole. The analyses revealed significant relationships between blood phenylalanine levels from ages 6 to 10 years and each of the cognitive outcome variables, after the influences of parental IQ and the age at which treatment was initiated were controlled for. Intelligence test scores were also related to phenylalanine levels between ages 3 1/2 and 5 1/2 years. The findings suggest that dietary restriction of phenylalanine should continue in patients with PKU through at least 10 years of age.

Child↗

A comparison of surgical and prosthetic treatment for speech disorders attributable to surgically acquired soft palate defects.

Surgical and prosthetic treatments for speech disorders attributable to surgically acquired soft palate defects were investigated. Ten patients who had undergone soft palate resection for extensive cancer served as the subjects. In four patients, the resected portion of the soft palate was confined to the anterior or middle segments, with an intact posterior band, whereas in the remaining six patients the resected portion extended into the posterior edge. An obturator with or without a speech appliance was adapted to all patients in the former group and to one patient in the latter group. The remaining five patients in the latter group underwent surgical reconstruction using a free radial forearm flap immediately after resection of the soft palate. The speech of each patient was evaluated either before and after surgery in those treated only surgically or with and without the obturator in the other patients using a standard intelligibility test of 100 Japanese syllables. These tests showed that two of the four patients with a posterior band of soft palate remaining postsurgically achieved excellent restoration of speech and improvement of velopharyngeal function following placement of a special prosthesis. The patients who had resection extending into the posterior edge of the soft palate obtained better restoration of speech and function from surgical reconstruction rather than prosthetic management. All three patients who had surgical reconstruction, in whom the special obturator was applied achieved a slight increase in speech intelligibility scores resulting from the improvement of velopharyngeal function. These results suggest that surgical reconstruction and prosthetic management may best be applied selectively based on the extent of resection of the soft palate.

Adult↗

Measuring emotional intelligence with the MSCEIT V2.0.

Does a recently introduced ability scale adequately measure emotional intelligence (EI) skills? Using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT; J. D. Mayer, P. Salovey, & D. R. Caruso, 2002b), the authors examined (a) whether members of a general standardization sample and emotions experts identified the same test answers as correct, (b) the test's reliability, and (c) the possible factor structures of EI. Twenty-one emotions experts endorsed many of the same answers, as did 2,112 members of the standardization sample, and exhibited superior agreement, particularly when research provides clearer answers to test questions (e.g., emotional perception in faces). The MSCEIT achieved reasonable reliability, and confirmatory factor analysis supported theoretical models of EI. These findings help clarify issues raised in earlier articles published in Emotion.

Adaptation, Psychological↗

Patterns of cognitive ageing.

Neuroanatomical evidence suggests that normal ageing affects some brain areas, and the "local" functions they support, earlier and more severely than others. Changes appear to be especially marked in the hippocampus, temporal association and prefrontal cortex. Evidence from classical neuropsychological studies suggests that these brain areas are associated with memory and "executive" functions, respectively. We may, therefore, expect that tests purported to measure these functions may be disproportionately affected in old age and that there may be evidence for some separation of these functions even within neurologically normal populations. What we also know, however, is that measures reflecting general fluid ability also decline with increasing age, so any hypothesis relating to specific "local" deficits must acknowledge and account for any "globar" changes in performance. Volunteers (n = 162) aged between 60-80 years who had completed the Cattell and Cattell Culture Fair Intelligence Test (CCF) completed the Cambridge Automated Neuropsychological Test Battery (CANTAB). The CANTAB has been administered to several patient populations and tests from the battery have been shown to be sensitive to damage in both temporal and prefrontal areas (Owen et al., 1996). Results from the test battery showed that both the Paired Associate Learning and Spatial Recognition tests were the most sensitive to normal ageing even when CCF is accounted for. In contrast, this performance on the "executive" tests, shown to be sensitive to frontal lobe damage was not related to age, and CCF scores predicted performance on these tests. These results are discussed in relation to theories of cognitive ageing and patterns of change and in relation to several important methodological and theoretical considerations for the study of executive function.

Aged↗

Relationship of emotional intelligence and adherence to combination antiretroviral medications by individuals living with HIV disease.

Medications are an intentional and purposeful means to the successful management of many chronic diseases. In the treatment of disease caused by HIV, adherence to medication is of particular concern because any level of nonadherence, often a few missed doses, will lead eventually to the development of drug resistance. Many predictors of poor adherence to HIV medications have been identified as significant factors in adherence. Among these is the emotional aspect. The purpose of this study was to examine emotional intelligence (EI) and adherence to combination antiretroviral therapy in individuals who are infected with HIV. EI is defined as the ability to perceive and express emotions, facilitate emotions, understand and reason with emotion, and manage emotions. EI has been correlated with various aspects of success in life. In this study, EI was measured by the Mayer, Salovey, Caruso Emotional Intelligence Test. Adherence to medications was measured by self-report and defined as less than 10% missed doses of medications. Eighty-two participants were recruited from an urban hospital-based HIV clinic. Pearson's r was used to analyze the data for significance, and no correlation was reported. This data set was not large enough to prove significance, statistically, of the research question. However, an unexpected result of this study was that the overall EI scores for this particular population were markedly lower than the test norms. Further study would be warranted and recommended to explore El measurement in people at risk for HIV disease or in those who have the disease to further understand the impact of emotions and EI in this specific population.

Adult↗

Frequency of radiographic procedures in an urban 62-year-old population in relation to general health, body build, bone mineral content, locomotor discomfort, occupational work load and socio-economic factors.

For 830 62-year-old residents of the city of Malmö records of radiographic examinations made over a period of 40 years at the Radiological Department of Malmö General Hospital and/or over 20-30 years at two private radiological departments in the city were reviewed. Radiographic examination had been undertaken in 92% of the residents, with on an average 16 examinations per resident. The most common examinations were of the chest in 63% of the residents followed by lower limb (58%) and spine (52%) examinations. In men the total number of radiographic examinations were negatively correlated to income, intelligence test results and social network and job satisfaction. Men with monotonous work and a more restricted latitude for decision-making at work, as well as men who were smokers had also had significantly more radiographic examinations. Single civil status and occupational work load had in men a positive correlation with the total number of radiographic examinations, as well as with serum levels of glutamyltransferase and uric acid levels. In women there was a negative correlation between radiographic examinations and teachers' rating of intelligence in childhood and bone mineral content, whereas job satisfaction, life success and triceps skinfold index (= subcutaneous fat tissue thickness) had a positive correlation with the total number of radiographic examinations. Women who took regular exercise (every week) had had significantly fewer radiographic examinations. Men and women with locomotor discomfort had a significantly higher consumption of not only musculoskeletal radiographic examinations but also other radiographic examinations.

Confidence Intervals↗

Elbow flexion response as another primitive reflex.

In daily clinical practice we noticed that patients with intellectual impairment spontaneously flex the elbow within a few seconds of the forearm being manipulated during routine examination of spasticity of the muscles in the upper extremities. We termed this phenomenon elbow flexion response (EFR), and prospectively studied it in 229 patients who underwent in-hospital rehabilitation following brain damage. Evaluation of each patient included EFR, patient profile, ability to communicate, scores on three parameters from various intelligence tests, scores on seven parameters testing primitive reflexes, and scores on three parameters describing personality. We investigated for relationships among these parameters. Consequently, although EFR rarely have a statistical association with the varied profiles of patients, patients with bilateral lesion or bilateral paresis demonstrated significantly more marked EFR than those with unilateral lesion or unilateral paresis. Patients with involvement of the frontal lobe showed significantly more marked EFR than those without damage in this area. Elbow flexion responses occurred significantly more frequently in relation with lower scores on intelligence and occurred with significantly higher frequency in conjunction with the more marked appearance of conventional primitive reflexes. Therefore, we conclude that EFR have a strong association with intelligence and with the existence of frontal lobe lesion, and their mode of clinical presentation parallels that of primitive reflexes particularly that of the grasp reflex. We propose that EFR could be referred as a variation of the grasp reflex occurring in the more proximal or axial part of the body.

Brain Injuries↗

On the combined effects of signal-to-noise ratio and room acoustics on speech intelligibility.

Speech intelligibility in rooms is influenced by room acoustics effects and by the signal-to-noise ratio (S/N) of the speech and ambient noise. Several measures such as useful-to-detrimental sound ratios and the speech transmission index predict the combined effects of both types of factors. These measures were evaluated relative to speech intelligibility test results obtained in simulated sound fields. The use of simulated sound fields made it possible to create the full range of combinations of room acoustics and S/N effects likely to be found in rooms for speech. The S/N aspect is shown to be much more important than room acoustics effects and new broadband useful-to-detrimental ratios were validated. Useful-to-detrimental ratios, speech transmission index measures, and values of the articulation loss for consonants were all reasonably accurate predictors of speech intelligibility. Further improvements to these combined measures are suggested.

Environment↗

Differences in reading achievement between spina bifida children attending normal schools and those attending special schools.

This paper reports the reading scores measured on Neale's Analysis of Reading Ability of a series of 55 spina bifida children, some of whom attended normal schools and the remainder attended special schools and matched controls. A multiple regression equation was used to compare observed scores with the expected scores. The children receiving a normal school education were reading up to the level expected from their intelligence test scores, but the children in special schools had significant differences between observed and expected scores. The discrepancies may be accounted for by more profound physical handicap among the special school children but teachers' expectations may also be important in influencing reading achievement.

Achievement↗

Cathepsin D exon 2 polymorphism associated with general intelligence in a healthy older population.

General intelligence is a heritable trait that is a risk factor for both the onset of dementia and the rate of cognitive decline in community-dwelling older persons. Previous studies screening for quantitative trait loci (QTLs) that influence general intelligence in healthy individuals have identified four loci, two of which are located within the genes insulin-like growth factor 2 receptor (IGF2R) and the Msx1 homeobox. Here, we report the finding of another QTL associated with general intelligence that is located within exon 2 of the cathepsin D (CTSD) gene. A group of 767 healthy adults with a follow-up period of over 15 years have been analyzed for cross-sectional and longitudinal trends in cognitive change using the Heim intelligence test score (AH4-1). We observed a significant association (P = 0.01) between a functional C > T (Ala > Val) transition within exon 2 of the CTSD gene that increases the secretion of pro-CTSD from the cell, and the AH4-1 score at initial testing on entry to the longitudinal study. Interestingly, CTSD is transported by IGF2R from the trans Golgi network to the lysosome.

Aged↗

Acoustic characteristics of voice after severe traumatic brain injury.

OBJECTIVES/HYPOTHESIS: To describe the acoustic characteristics of voice in individuals with motor speech disorders after traumatic brain injury (TBI). STUDY DESIGN: Prospective study of 100 individuals with TBI based on consecutive referrals for motor speech evaluations. METHODS: Subjects were audio tape-recorded while producing sustained vowels and single word and sentence intelligibility tests. Laryngeal airway resistance was estimated, and voice quality was rated perceptually. RESULTS: None of the subjects evidenced vocal parameters within normal limits. The most frequently occurring abnormal parameter across subjects was amplitude perturbation, followed by voice turbulence index. Twenty-three percent of subjects evidenced deviation in all five parameters measured. The perceptual ratings of breathiness were significantly correlated with both the amplitude perturbation quotient and the noise-to-harmonics ratio. CONCLUSIONS: Vocal quality deviation is common in motor speech disorders after TBI and may impact intelligibility.

Adult↗

SYSTEMS: School-Years Screening Test for the Evaluation of Mental Status.

This paper introduces the School-Years Screening Test for Evaluation of Mental Status (SYSTEMS). It was designed to be used by neurologists, pediatricians, and other health professionals assessing children with suspected cognitive problems or changes. SYSTEMS was initially based on the adult Mini-Mental State Examination developed by Folstein, Folstein, and McHugh in 1975. SYSTEMS is a 7- to 12-minute, one-on-one interview test containing 46 items for use in children between 5 and 12 years of age. Although a full diagnosis cannot be made, the results do provide an indication of whether to send a child for further detailed cognitive assessment. The development of SYSTEMS comprised seven studies with a total of 1207 children involved from Sydney primary schools and neurology clinics of the New Children's Hospital, Westmead, New South Wales, Australia. All children were administered the SYSTEMS. Some of the children also were administered the Stanford-Binet Intelligence Test, 4th edition, or the Differential Ability Scales. Results showed that the SYSTEMS was internally consistent, unbiased by sex, socioeconomic indicators, or language groups; discriminated well by age; and strongly correlated (r = 0.88) with mental age. No significant differences in results obtained by two trained administrators were evident and no indication of apparent practice effect was found. The SYSTEMS was found to have desirable levels of sensitivity (83% and 92%), specificity (76% and 95%), and likelihood ratio for cognitive impairment (3.63 and 17.5) when compared with neurologic judgments and the Differential Ability Scales, respectively.

Child↗

There is a direct relationship between nonverbal intelligence and serum testosterone level in young men.

It was confirmed that there is a direct relationship between serum testosterone level and nonverbal intelligence (Cattel's Culture Fair Intelligence Test) only in right-handed male subjects without familial sinistrality (FS-), with right eye preference. There was no significant correlation between these variables in young women and young men with mixed eye preference. It was concluded that testosterone would be an important factor which affects cognitive development in men.

Adolescent↗