The Electrochemical-Step Asymmetry Index

Background: We have hypothesized that Parkinson’s disease (PD) comprises two subtypes. Brain-first, where pathogenic α-synuclein initially forms unilaterally in one hemisphere leading to asymmetric nigrostriatal degeneration, and body-first with initial enteric pathology, which spreads through overlapping vagal innervation leading to more symmetric brainstem involvement and hence more symmetric nigrostriatal degeneration. Isolated REM sleep behaviour disorder has been identified as a strong marker of the body-first type. Objective: To analyse striatal asymmetry in [18F]FDOPA PET and [123I]FP-CIT DaT SPECT data from iRBD patients, de novo PD patients with RBD (PD +RBD) and de novo PD patients without RBD (PD - RBD). These groups were defined as prodromal body-first, de novo body-first, and de novo brain-first, respectively. Methods: We included [18F]FDOPA PET scans from 21 iRBD patients, 11 de novo PD +RBD, 22 de novo PD - RBD, and 18 controls subjects. Also, [123I]FP-CIT DaT SPECT data from iRBD and de novo PD patients with unknown RBD status from the PPPMI dataset was analysed. Lowest putamen specific binding ratio and putamen asymmetry index (AI) was defined. Results: Nigrostriatal degeneration was significantly more symmetric in patients with RBD versus patients without RBD or with unknown RBD status in both FDOPA (p = 0.001) and DaT SPECT (p = 0.001) datasets. Conclusion: iRBD subjects and de novo PD +RBD patients present with significantly more symmetric nigrostriatal dopaminergic degeneration compared to de novo PD - RBD patients. The results support the hypothesis that body-first PD is characterized by more symmetric distribution most likely due to more symmetric propagation of pathogenic α-synuclein compared to brain-first PD.

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Analyzing the Magnitude of Interlimb Asymmetries in Young Female Soccer Players: A Preliminary Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020475 ◽

2021 ◽

Vol 18 (2) ◽

pp. 475

Author(s):

Javier Raya-González ◽

Filipe Manuel Clemente ◽

Daniel Castillo

Keyword(s):

Range Of Motion ◽

Muscle Mass ◽

Injury Risk ◽

Young Female ◽

Asymmetry Index ◽

Lower Limbs ◽

Soccer Players ◽

Countermovement Jump ◽

Change Of Direction ◽

Jump Ability

Although asymmetries in lower limbs have been linked with players’ performance in male soccer players, literature that has been published addressing female soccer is scarce. Thus, the aim of this study was twofold: (i) describe the asymmetries of women soccer players during jumping, change-of-direction and range-of-motion tests; and (ii) test possible relationships between asymmetries and injury risk in female soccer players. Sixteen female players (15.5 ± 1.5 years) performed a battery of fitness tests (i.e., jump ability, change-of-direction ability and passive range-of-motion) and muscle mass analysis via dual-energy X-ray absorptiometry, through which the specific asymmetry index and the related injury risk were calculated. Significant (p < 0.05) lower asymmetries in the change-of-direction test were observed in comparison to those observed in jumping and range-of-motion tests; significant (p < 0.05) lower asymmetries in muscle mass were also reported compared to those found in the change-of-direction and countermovement jump tests. Additionally, increased injury risk for countermovement jump and hip flexion with extended knee range-of-motion (relating to asymmetry values) and for ankle flexion with flexed knee range-of-motion in both legs (relating to reference range-of-motion values), as well as increased individual injury risk values, were observed across all tests. These findings suggest the necessity to implement individual approaches for asymmetry and injury risk analyses.

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Long term results of accelerated 9 mW corneal crosslinking for early progressive keratoconus: the Siena Eye-Cross Study 2

Eye and Vision ◽

10.1186/s40662-021-00240-8 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Cosimo Mazzotta ◽

Frederik Raiskup ◽

Farhad Hafezi ◽

Emilio A Torres-Netto ◽

Ashraf Armia Balamoun ◽

...

Keyword(s):

Visual Acuity ◽

Corneal Thickness ◽

Continuous Light ◽

Clinical Results ◽

Asymmetry Index ◽

Long Term Results ◽

Distance Visual Acuity ◽

Long Term Stability ◽

Uncorrected Distance Visual Acuity

Abstract Purpose To assess clinical results of the 9 mW/5.4 J/cm2 accelerated crosslinking (ACXL) in the treatment of progressive keratoconus (KC) over a span of 5 years. Methods The prospective open non-randomized interventional study (Siena Eye-Cross Study 2) included 156 eyes of 112 patients with early progressive KC undergoing the Epi-Off 9 mW/5.4 J/cm2 ACXL at the Siena Crosslinking Centre, Italy. The mean age was 18.05 ± 5.6 years. The 20-min treatments were performed using the New KXL I (Avedro, Waltham, USA), 10 min of 0.1% HPMC Riboflavin soaking (VibeX Rapid, Avedro, Waltham, USA) and 10 min of continuous-light UV-A irradiation. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), Kmax, coma, minimum corneal thickness (MCT), surface asymmetry index (SAI), endothelial cell count (ECC) were measured, and corneal OCT performed. Results UDVA and CDVA improved significantly at the 3rd (P = 0.028), Δ + 0.17 Snellen lines and 6th postoperative month, respectively (P < 0.001), Δ + 0.23 Snellen lines. Kmax improved at the 6th postoperative month (P = 0.03), Δ − 1.49 diopters from the baseline value. Also, coma aberration value improved significantly (P = 0.004). A mild temporary haze was recorded in 14.77% of patients without affecting visual acuity and without persistent complications. Corneal OCT revealed a mean demarcation line depth at 332.6 ± 33.6 μm. Conclusion The 5-year results of Epi-Off 9 mW/5.4 J/cm2 ACXL demonstrated statistically significant improvements in UCVA and CDVA, corneal curvature and corneal higher-order aberrations which confers a long-term stability for progressive ectasia. Based on the results of the Siena Eye-Cross Study 2, the 9 mW/5.4 J/cm2 ACXL is a candidate to be the natural evolution of Epi-Off CXL treatment for the management of early progressive corneal ectasia, and thus optimize clinic workflow.

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Efficacy of pediatric integrative manual therapy in positional plagiocephaly: a randomized controlled trial

Italian Journal of Pediatrics ◽

10.1186/s13052-021-01079-4 ◽

2021 ◽

Vol 47 (1) ◽

Author(s):

Iñaki Pastor-Pons ◽

María Orosia Lucha-López ◽

Marta Barrau-Lalmolda ◽

Iñaki Rodes-Pastor ◽

Ángel Luis Rodríguez-Fernández ◽

...

Keyword(s):

Manual Therapy ◽

Education Program ◽

Controlled Trial ◽

Asymmetry Index ◽

Trial Registration ◽

Control Group ◽

Parental Perception ◽

Positional Plagiocephaly ◽

Caregiver Education ◽

Registration Number

Abstract Background Positional plagiocephaly frequently affects healthy babies. It is hypothesized that manual therapy tailored to pediatrics is more effective in improving plagiocephalic cranial asymmetry than just repositioning and sensory and motor stimulation. Methods Thirty-four neurologically healthy subjects aged less than 28 weeks old with a difference of at least 5 mm between cranial diagonal diameters were randomly distributed into 2 groups. For 10 weeks, the pediatric integrative manual therapy (PIMT) group received manual therapy plus a caregiver education program, while the controls received the same education program exclusively. Cranial shape was evaluated using anthropometry; cranial index (CI) and cranial vault asymmetry index (CVAI) were calculated. Parental perception of change was assessed using a visual analogue scale (− 10 cm to + 10 cm). Results CVAI presented a greater decrease in PIMT group: 3.72 ± 1.40% compared with 0.34 ± 1.72% in the control group (p = 0.000). CI did not present significant differences between groups. Manual therapy led to a more positive parental perception of cranial changes (manual therapy: 6.66 ± 2.07 cm; control: 4.25 ± 2.31 cm; p = 0.004). Conclusion Manual therapy plus a caregiver education program improved CVAI and led to parental satisfaction more effectively than solely a caregiver education program. Trial registration Trial registration number: NCT03659032; registration date: September 1, 2018. Retrospectively registered.

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Mandibular Asymmetry in Different Occlusion Patterns

The Angle Orthodontist ◽

10.2319/092506-392 ◽

2007 ◽

Vol 77 (5) ◽

pp. 803-807 ◽

Cited By ~ 26

Author(s):

Omer Said Sezgin ◽

Peruze Celenk ◽

Selim Arici

Keyword(s):

Class Ii ◽

Asymmetry Index ◽

Control Group ◽

Class Iii ◽

Mandibular Asymmetry ◽

Normal Occlusion ◽

Division 1 ◽

Index Value ◽

Age Range ◽

Division 2

Abstract Objective: To investigate the effects of different occlusion types on the mandibular asymmetry in young individuals. Materials and Methods: Mandibular asymmetry measurements were performed on the panoramic radiographs of 189 subjects (104 females and 85 males; age range, 11–15 years), with different occlusion patterns. The subjects were divided into five groups according to the occlusion types, namely, Angle Class I (Cl I), Class II division 1 (Cl II/1), Class II division 2 (Cl II/2), Class III (Cl III), and normal occlusions. The Kruskal-Wallis test was used to determine the possible statistically significant differences between the groups for condyle, ramus, and condyle-plus-ramus asymmetry index measurements. Identified differences between groups were further analyzed using the Mann-Whitney U-test at the 95% confidence interval (P < .05). Results: There were no statistically significant differences between male and female subjects. The Kruskal-Wallis test showed that the occlusion type had a significant effect on the condylar asymmetry. In Cl II/1 cases, condylar asymmetry values were significantly different from the values of Cl II/2 and Cl III malocclusion and normal occlusion types. The normal occlusion control group was significantly different from those of Cl II/1 and the Cl I malocclusion groups. Conclusion: Cl II/1 malocclusion has a significant effect on the condylar asymmetry index when compared to Cl II/2 and Cl III malocclusion and normal occlusion types. However, the mean condylar asymmetry index value in Cl II/1 malocclusion was not different from Cl I malocclusion.

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Image processing and machine learning for telehealth craniosynostosis screening in newborns

Journal of Neurosurgery Pediatrics ◽

10.3171/2020.9.peds20605 ◽

2021 ◽

pp. 1-8

Author(s):

Markus J. Bookland ◽

Edward S. Ahn ◽

Petronella Stoltz ◽

Jonathan E. Martin

Keyword(s):

Image Processing ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Asymmetry Index ◽

Optical Measurements ◽

Shape Classification ◽

Data Set ◽

Intraclass Correlation Coefficients ◽

Optical Scanner ◽

Cranial Shape

OBJECTIVE The authors sought to evaluate the accuracy of a novel telehealth-compatible diagnostic software system for identifying craniosynostosis within a newborn (< 1 year old) population. Agreement with gold standard craniometric diagnostics was also assessed. METHODS Cranial shape classification software accuracy was compared to that of blinded craniofacial specialists using a data set of open-source (n = 40) and retrospectively collected newborn orthogonal top-down cranial images, with or without additional facial views (n = 339), culled between April 1, 2008, and February 29, 2020. Based on image quality, midface visibility, and visibility of the cranial equator, 351 image sets were deemed acceptable. Accuracy, sensitivity, and specificity were calculated for the software versus specialist classification. Software agreement with optical craniometrics was assessed with intraclass correlation coefficients. RESULTS The cranial shape classification software had an accuracy of 93.3% (95% CI 86.8–98.8; p < 0.001), with a sensitivity of 92.0% and specificity of 94.3%. Intraclass correlation coefficients for measurements of the cephalic index and cranial vault asymmetry index compared to optical measurements were 0.95 (95% CI 0.84–0.98; p < 0.001) and 0.67 (95% CI 0.24–0.88; p = 0.003), respectively. CONCLUSIONS These results support the use of image processing–based neonatal cranial deformity classification software for remote screening of nonsyndromic craniosynostosis in a newborn population and as a substitute for optical scanner– or CT-based craniometrics. This work has implications that suggest the potential for the development of software for a mobile platform that would allow for screening by telemedicine or in a primary care setting.

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Gait Study of Parkinson’s Disease Subjects Using Haptic Cues with A Motorized Walker

Sensors ◽

10.3390/s18103549 ◽

2018 ◽

Vol 18 (10) ◽

pp. 3549 ◽

Cited By ~ 3

Author(s):

Minhua Zhang ◽

N. Artan ◽

Huanying Gu ◽

Ziqian Dong ◽

Lyudmila Burina Ganatra ◽

...

Keyword(s):

Parkinson’S Disease ◽

New York ◽

Parkinson's Disease ◽

Gait Cycle ◽

Asymmetry Index ◽

Gait Symmetry ◽

Double Support ◽

College Of Osteopathic Medicine ◽

Institute Of Technology ◽

Gait Abnormalities

Gait abnormalities are one of the distinguishing symptoms of patients with Parkinson’s disease (PD) that contribute to fall risk. Our study compares the gait parameters of people with PD when they walk through a predefined course under different haptic speed cue conditions (1) without assistance, (2) pushing a conventional rolling walker, and (3) holding onto a self-navigating motorized walker under different speed cues. Six people with PD were recruited at the New York Institute of Technology College of Osteopathic Medicine to participate in this study. Spatial posture and gait data of the test subjects were collected via a VICON motion capture system. We developed a framework to process and extract gait features and applied statistical analysis on these features to examine the significance of the findings. The results showed that the motorized walker providing a robust haptic cue significantly improved gait symmetry of PD subjects. Specifically, the asymmetry index of the gait cycle time was reduced from 6.7% when walking without assistance to 0.56% and below when using a walker. Furthermore, the double support time of a gait cycle was reduced by 4.88% compared to walking without assistance.

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