scholarly journals Gait differences in patients with multiple sclerosis who have low and high levels of disability

2019 ◽  
Author(s):  
John J. Fraser ◽  
Jeannie B. Stephenson
Keyword(s):  
Multiple Sclerosis ◽  
Analysis Of Variance ◽  
Cycle Time ◽  
Correlation Coefficients ◽  
Effect Sizes ◽  
Intra Class Correlation ◽  
Gait Impairment ◽  
Gait Characteristics ◽  
Disability Group

AbstractBackgroundMultiple Sclerosis (MS) often results in gait impairment and disability.ObjectiveTo investigate differences in spatiotemporal gait characteristics of people with MS who have low versus high levels of disability. Between trial and inter-limb consistency and the association of gait variables with level of disability were also investigated.MethodsParticipants with MS who had either low-disability [n=7; 3 females; EDSS mean: 2.7±0.5, range 2.0-4.5; BMI=26.9±6.6] or high-disability [n=11; 6 females; EDSS mean: 2.7±0.5, range 6.0-6.5; BMI=27.8±1.5) performed 2 trials of self-selected walking on an instrumented walkway. Differences in group, limb, and group by limb interactions were assessed using analysis of variance, independent-measures t-tests, and Cohen’s d effect sizes (ES). Between-trial consistency of gait were assessed with intra-class correlation coefficients (2, k).ResultsParticipants in the high disability group had increased step time (ES=0.8), cycle time (ES=0.8), and ambulation time (ES=1.2) while taking shorter strides (ES=0.9) and more steps at a slower rate (ES=1.1). The high disability group demonstrated less between-trial consistency for 69% of gait variables when compared to the low disability group.ConclusionPeople with MS who have high levels of disability walk differently and with less consistency than those with lower levels of disability.

Prediction of lymph node metastase in NSCLC

2010 ◽  
Vol 01 (05) ◽  
pp. 219-226 ◽  
Author(s):  
F. Beyer ◽  
B. Buerke ◽  
J. Gerss ◽  
K. Scheffe ◽  
M. Puesken ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Fdg Pet ◽  
Automatic Segmentation ◽  
Correlation Coefficients ◽  
Mediastinal Lymph Nodes ◽  
Intra Class Correlation ◽  
Axial Diameter ◽  
Pet Ct ◽  
Fdg Pet Ct

SummaryPurpose: To distinguish between benign and malignant mediastinal lymph nodes in patients with NSCLC by comparing 2D and semiautomated 3D measurements in FDG-PET-CT.Patients, material, methods: FDG-PET-CT was performed in 46 patients prior to therapy. 299 mediastinal lymph-nodes were evaluated independently by two radiologists, both manually and by semi-automatic segmentation software. Longest-axial-diameter (LAD), shortest-axial-diameter (SAD), maximal-3D-diameter, elongation and volume were obtained. FDG-PET-CT and clinical/FDG-PET-CT follow up examinations and/or histology served as the reference standard. Statistical analysis encompassed intra-class-correlation-coefficients and receiver-operator-characteristics-curves (ROC). Results: The standard of reference revealed involvement in 87 (29%) of 299 lymph nodes. Manually and semi-automatically measured 2D parameters (LAD and SAD) showed a good correlation with mean

Counter culture: Causes, extent and solutions of systematic bias in the analysis of behavioural counts

2019 ◽  
Author(s):  
Joel L Pick ◽  
Nyil Khwaja ◽  
Michael A. Spence ◽  
Malika Ihle ◽  
Shinichi Nakagawa
Keyword(s):  
Recent Literature ◽  
Null Model ◽  
Mechanistic Explanation ◽  
Effect Sizes ◽  
Systematic Bias ◽  
Intra Class Correlation ◽  
Counter Culture ◽  
Provisioning Rate ◽  
Parental Provisioning ◽  
Observation Period

We often quantify a behaviour by counting the number of times it occurs within a specific, short observation period. Measuring behaviour in such a way is typically unavoidable but induces error. This error acts to systematically reduce effect sizes, including metrics of particular interest to behavioural and evolutionary ecologists such as R2, repeatability (intra-class correlation, ICC) and heritability. Through introducing a null model, the Poisson process, for modelling the frequency of behaviour, we give a mechanistic explanation of how this problem arises and demonstrate how it makes comparisons between studies and species problematic, because the magnitude of the error depends on how frequently the behaviour has been observed (e.g. as a function of the observation period) as well as how biologically variable the behaviour is. Importantly, the degree of error is predictable and so can be corrected for. Using the example of parental provisioning rate in birds, we assess the applicability of our null model for modelling the frequency of behaviour. We then review recent literature and demonstrate that the error is rarely accounted for in current analyses. We highlight the problems that arise from this and provide solutions. We further discuss the biological implications of deviations from our null model, and highlight the new avenues of research that they may provide. Adopting our recommendations into analyses of behavioural counts will improve the accuracy of estimated effect sizes and allow meaningful comparisons to be made between studies.

scholarly journals Responsiveness of the Scripps Neurologic Rating Scale During a Multiple Sclerosis Clinical Trial

1999 ◽  
Vol 26 (4) ◽  
pp. 283-289 ◽  
Author(s):  
James A. Koziol ◽  
Adriana Lucero ◽  
Jack C. Sipe ◽  
John S. Romine ◽  
Ernest Beutler
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Trial ◽  
Rating Scale ◽  
Effect Sizes ◽  
Active Therapy ◽  
Double Blind ◽  
Treatment Groups ◽  
Negative Effect ◽  
The Individual ◽  
Positive Effect

Objective:The Scripps neurologic rating scale (SNRS) is a summary measure of individual components comprising a neurological examination, designed for use in multiple sclerosis (MS). Our objective is to evaluate the responsiveness of the SNRS, within the context of a 2-year, randomized, double-blind crossover study of the efficacy of cladribine for treatment of secondary progressive MS.Methods:Effect sizes were determined for the SNRS and its components, separately for each treatment group (initial placebo, and initial cladribine) over both years of the clinical trial, using a standard random effects model.Results:Individual components tended to show positive effect sizes (improvement) during periods of active therapy in both treatment groups, and negative effect sizes (deterioration) during periods of no active therapy. Summation indices derived from the individual components of the SNRS seemed somewhat more stable than the individual components. The two components mentation and mood, and bladder, bowel, or sexual dysfunction, were rather unresponsive in our clinical trial.Conclusion:Changes in the components of the SNRS over the course of our clinical trial were consistent between the two treatment groups. Most components were moderately responsive; and, the summary SNRS score appropriately summarized the moderate magnitudes of change evinced in the individual components.

scholarly journals Objectivation of an Educational Model in Cranial Osteopathy Based on Experience

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 246
Author(s):  
Jesús Requena-García ◽  
Evelyn García-Nieto ◽  
David Varillas-Delgado
Keyword(s):  
Scientific Evidence ◽  
Correlation Coefficients ◽  
Lateral Compression ◽  
Educational Model ◽  
Reliability Study ◽  
Intra Class Correlation ◽  
Observer Reliability ◽  
Fundamental Part ◽  
Manual Palpation ◽  
Base Of The Skull

Background and Objectives: The techniques directed to the cranial field in osteopathy are the most questioned due to the lack of scientific evidence. In osteopathic practice, manual palpation is essential and, therefore, measuring reliability is fundamental. The objective of this study is to assess the precision and objectification of an educational model in cranial osteopathy based on experience. Materials and Methods: A reliability study was conducted in a cadaver skull where a strain gauge was placed on the sphenobasilar synchondrosis (SBS) of the base of the skull. Three cranial osteopathic techniques (lateral compression, anteroposterior compression, and compression maneuver of the mastoids) were performed 25 times by osteopaths with different degrees of experience (5–10 years, 1–5 years, <1 year). Measurements were computed for each of the three techniques of each group in comparison with the osteopath with >15 years of experience. Data were analyzed to check for inter- and intra-observer reliability using intra-class correlation coefficients (ICC). Results: Reliability in osteopaths with 5–10 years’ experience (observer 1 and observer 2) performing all three techniques was higher (p < 0.001) than the osteopath with >15 years’ experience. Little or no reliability were observed in osteopaths with less experience. Conclusions: The experience of the osteopaths determines the reliability and effectiveness of the cranial techniques, a fundamental part in objectifying these techniques. This model can help implement objective training in cranial osteopathy formation.

Depression and Inflammatory Markers in Veterans With Multiple Sclerosis

2021 ◽  
pp. 109980042110500
Author(s):  
Pamela Newland ◽  
Yelyzaveta Basan ◽  
Ling Chen ◽  
Gregory Wu
Keyword(s):  
Multiple Sclerosis ◽  
Inflammatory Markers ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
The United States ◽  
Biological Mechanisms ◽  
The Central Nervous System ◽  
Brain And Spinal Cord ◽  
The Brain

Multiple sclerosis (MS), an inflammatory neurodegenerative disease of the central nervous system (CNS), afflicts over one per thousand people in the United States. The pathology of MS typically involves lesions in several regions, including the brain and spinal cord. The manifestation of MS is variable and carries great potential to negatively impact quality of life (QOL). Evidence that inflammatory markers are related to depression in MS is accumulating. However, there are barriers in precisely identifying the biological mechanisms underlying depression and inflammation. Analysis of cytokines provides one promising approach for understanding the mechanisms that may contribute to MS symptoms. Methods: In this pilot study, we measured salivary levels of interleukin (IL)-6, IL-1beta (β), and IL-10 in 24 veterans with MS. Descriptive statistics were reported and Pearson correlation coefficients were obtained between cytokines and depression. Results: The anti-inflammatory cytokine IL-10 was significantly negatively associated with depression in veterans with MS (r = −0.47, p = .024). Conclusion: Cytokines may be useful for elucidating biological mechanisms associated with the depression and a measure for nurses caring for veterans with MS.

A trait of mind: stability and robustness of sleep across sleep opportunity manipulations during simulated military operational stress

SLEEP ◽  
2021 ◽  
Author(s):  
Alice D LaGoy ◽  
J David Cashmere ◽  
Meaghan E Beckner ◽  
Shawn R Eagle ◽  
Aaron M Sinnott ◽  
...  
Keyword(s):  
Military Personnel ◽  
Correlation Coefficients ◽  
Sleep Architecture ◽  
Sleep Restriction ◽  
Spectral Parameters ◽  
Intra Class Correlation ◽  
Operational Stress ◽  
Spectral Activity ◽  
Sleep Parameters ◽  
The Stability

Abstract Study Objectives Within-subject stability of certain sleep features across multiple nights is thought to reflect the trait-like behavior of sleep. However, to be considered a trait, a parameter must be both stable and robust. Here, we examined the stability (i.e., across the same sleep opportunity periods) and robustness (i.e., across sleep opportunity periods that varied in duration and timing) of different sleep parameters. Methods Sixty-eight military personnel (14 W) spent 5 nights in the sleep laboratory during a simulated military operational stress protocol. After an adaptation night, participants had an 8-hour sleep opportunity (23:00–07:00) followed by 2 consecutive nights of sleep restriction and disruption which included two 2-hour sleep opportunities (01:00–03:00; 05:00–07:00) and, lastly, another 8-hour sleep opportunity (23:00–07:00). Intra-class correlation coefficients were calculated to examine differences in stability and robustness across different sleep parameters. Results Sleep architecture parameters were less stable and robust than absolute and relative spectral activity parameters. Further, relative spectral activity parameters were less robust than absolute spectral activity. Absolute alpha and sigma activity demonstrated the highest levels of stability that were also robust across sleep opportunities of varying duration and timing. Conclusions Stability and robustness varied across different sleep parameters, but absolute NREM alpha and sigma activity demonstrated robust trait-like behavior across variable sleep opportunities. Reduced stability of other sleep architecture and spectral parameters during shorter sleep episodes as well as across different sleep opportunities has important implications for study design and interpretation.

Validation of the preference-based multiple sclerosis index

2018 ◽  
Vol 25 (11) ◽  
pp. 1496-1505 ◽  
Author(s):  
Ayse Kuspinar ◽  
Nancy E Mayo
Keyword(s):  
Multiple Sclerosis ◽  
Factor Analysis ◽  
Convergent Validity ◽  
Correlation Coefficients ◽  
Structural Validity ◽  
Related Quality ◽  
Health Related ◽  
Secondary Endpoints ◽  
Study Support ◽  
Generic Measures

Background: Preference-based measures of health-related quality of life (HRQL) are used as primary or secondary endpoints in multiple sclerosis (MS) research. Objective: The purpose of this paper was to evaluate the structural, convergent, and known-groups validity of the preference-based multiple sclerosis index (PBMSI) of HRQL in people with MS. Methods: Participants were recruited from three MS clinics in Montreal. Structural validity was assessed using polychoric correlation coefficients and factor analysis. To assess convergent validity, hypotheses were formulated about the strength of correlations between the PBMSI and other HRQL measures. Known-groups validity was assessed against different measures of disability. Results: The average age of the sample was 46 and 77% were women. Factor analysis supported the structural validity of the PBMSI; the items collectively were measuring one underlying construct. The PBMSI showed convergent validity against generic measures of HRQL, and known-groups validity between persons with different levels of disability. Conclusion: The results of this study support the construct validity of the PBMSI as an outcome measure of HRQL in MS. The PBMSI overcomes limitations observed with currently used HRQL measures in MS and may be used to contrast different interventions for people with MS.

Coefficients of Restitution of Balls Used in Team Sports for the Visually Impaired

1987 ◽  
Vol 3 (1) ◽  
pp. 63-68 ◽  
Author(s):  
Peter McGrain ◽  
James Van Dyke ◽  
James Mastro
Keyword(s):  
Factor Analysis ◽  
Analysis Of Variance ◽  
Visually Impaired ◽  
Team Sports ◽  
Correlation Coefficients ◽  
Videotape Recorder ◽  
Different Types

This study examined the coefficients of restitution (e) of selected balls used in team sports for the visually impaired: beep baseball and goal ball. Specifically, a basketball was compared to two men's standard goal balls, and a softball was compared to three different types of beep baseballs. The e for all balls was calculated by dropping each ball five times from heights of 6 ft (1.83 m) and 19.25 ft (5.88 m). A Sony reel-to-reel videotape recorder was used to record rebound heights on a background scale for each ball dropped. Reliability tests of the procedures yielded correlation coefficients (r) of 0.996 and 0.998 for the 6 ft (1.83 m) and 19.25 ft (5.88 m) drops, respectively. Two two-factor analysis of variance (ANOVA) tests yielded significant differences across ball type and height of drop for the basketball and goal balls and for the softball and beep baseballs, respectively (p < 0.001). The es for the more recently developed beep baseballs are close to that of the standard softball, indicating a possible danger to visually impaired participants in beep baseball.

scholarly journals Correlation between disability measure and Black Hole (T1 hypointense lesion) lesion load in brain magnetic resonance imaging of patients with multiple sclerosis: Protocol for a systematic review and meta-analysis

2021 ◽  
Author(s):  
Amir Valizadeh ◽  
Elham Barati ◽  
Mohammad Ali Sahraian ◽  
Mohammad Reza Fattahi ◽  
Mana Moassefi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Systematic Review ◽  
Web Of Science ◽  
Citation Index ◽  
Meta Analysis ◽  
Brain Magnetic Resonance Imaging ◽  
Correlation Coefficients ◽  
Resonance Imaging ◽  
Lesion Load

Abstract Rationale: As the role of neurodegeneration in the pathophysiology of multiple sclerosis (MS) has become more prominent, the formation and evolution of chronic or persistent T1-hypointense lesions (Black Holes) have been used as markers of axonal loss and neuronal destruction to measure disease activity. However, findings regarding this subject are controversial. In this study we aim to clarify the level of importance of T1 hypointense lesions for estimating the prognosis of patients.Objectives: To evaluate the correlation between T1 hypointensities (Black holes) lesion load (lesion mean volume) on brain MRI with disability level of patients with Relapsing-Remitting Multiple Sclerosis (RRMS) or Secondary-Progressive Multiple Sclerosis (SPMS).Data sources: We will search MEDLINE (through PubMed), Embase, CENTRAL, Science Citation Index – Expanded (Web of Science), and Conference Proceedings Citation Index – Science (Web of Science). We won’t consider any timeframe, language, or geographical restrictions.Methods: Standard systematic review protocol methodology is employed. Eligibility criteria is reported in line with PICOTS system. Population is limited to adult patients diagnosed with RRMS or SPMS, based on the McDonald criteria. Index (prognostic factor) of interest will be T1 hypointense (black hole) lesion mean volume (lesion load) on brain Magnetic Resonance Imaging (MRI). There will be no comparators. Outcome of interest will be the disability measure using Expanded Disability Status Scale (EDSS). For the timing domain, we will include studies only if the outcome was measured at the same time MRI was performed (or with a very close time interval between). Inpatient and outpatient settings will both be included. All included studies will be assessed for the risk of bias using a tailored version of the Quality In Prognosis Studies (QUIPS) tool. Extracted correlation coefficients will be converted to the Fisher’s z scale and a meta-analysis will be performed on the results. We will then convert back the results to correlation coefficients again for the sake of presentation. For the purpose of assessing heterogeneity we will use prediction intervals. If feasible, we will also try to perform subgroup and sensitivity analyses. We will also evaluate the publication bias using Funnel plots and assess the confidence in cumulative evidence using an adapted version of the GRADE for prognostic factor research.

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