Smartphone-Based Tapping Frequency as a Surrogate for Perceived Fatigue

Fatigue is a common symptom in various diseases, including multiple sclerosis (MS). The current standard method to assess fatigue is through questionnaires, which has several shortcomings; questionnaires are subjective, prone to recall bias, and potentially confounded by other symptoms like stress and depression. Thus, there is an unmet medical need to develop objective and reliable methods to evaluate fatigue. Our study seeks to develop an objective and ubiquitous monitoring tool for assessing fatigue. Leveraging a smartphone-based rapid tapping task, we conducted a two-week in-the-wild study with 35 MS patients. We explore the association between tapping derived metrics and perceived fatigue assessed with two standard clinical scales: fatigue severity scale (FSS) and fatigue scale for motor and cognitive function (FSMC). Our novel smartphone-based fatigue metric, mean tapping frequency, objectively ranks perceived fatigue with a mean AUCROC = .76, CI = [.71, .81] according to the FSMC, and a mean AUCROC = .81, CI = [.76, .86] according to the FSS. These results demonstrate that our approach is feasible and valid in uncontrolled environments. In this work, we provide a promising tool for objective fatigue monitoring to be used in clinical trials and routine medical care.

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Clinical Translational Potential in Skin Wound Regeneration for Adipose-Derived, Blood-Derived, and Cellulose Materials: Cells, Exosomes, and Hydrogels

Biomolecules ◽

10.3390/biom10101373 ◽

2020 ◽

Vol 10 (10) ◽

pp. 1373

Author(s):

Trivia Frazier ◽

Andrea Alarcon ◽

Xiying Wu ◽

Omair A. Mohiuddin ◽

Jessica M. Motherwell ◽

...

Keyword(s):

Skin Flap ◽

Healthcare Delivery ◽

Standard Of Care ◽

Research Area ◽

Skin Wound ◽

Current Status ◽

Current Standard ◽

Medical Need ◽

Pressure Injury ◽

Chronic Skin

Acute and chronic skin wounds due to burns, pressure injuries, and trauma represent a substantial challenge to healthcare delivery with particular impacts on geriatric, paraplegic, and quadriplegic demographics worldwide. Nevertheless, the current standard of care relies extensively on preventive measures to mitigate pressure injury, surgical debridement, skin flap procedures, and negative pressure wound vacuum measures. This article highlights the potential of adipose-, blood-, and cellulose-derived products (cells, decellularized matrices and scaffolds, and exosome and secretome factors) as a means to address this unmet medical need. The current status of this research area is evaluated and discussed in the context of promising avenues for future discovery.

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Pharmacologic Therapy for Multiple Sclerosis–Related Fatigue

International Journal of MS Care ◽

10.7224/1537-2073-7.1.22 ◽

2005 ◽

Vol 7 (1) ◽

pp. 22-27 ◽

Cited By ~ 1

Author(s):

Jay H. Rosenberg

Keyword(s):

Multiple Sclerosis ◽

Sleep Disturbances ◽

Well Being ◽

Pharmacologic Therapy ◽

Controlled Trials ◽

Common Symptom ◽

Impact Scale ◽

Moderate Fatigue ◽

The Central Nervous System ◽

Fatigue Severity

Fatigue is the most common symptom of multiple sclerosis and is perhaps the symptom with the most devastating impact on patient well-being. It is reported by 75% to 95% of individuals, and more than half describe it as the worst symptom of the disease. The mechanisms underlying the development of fatigue remain unclear; although fatigue is believed to be a primary symptom of MS (ie, related to the demyelinating processes of the disease), fatigue may also occur secondarily to factors such as sleep disturbances, depression, or the effects of medications. The highly variable presentation of MS and the number of agents used for disease modification and symptom management make it important for potential contributors to MS-related fatigue to be identified and managed appropriately. If fatigue continues despite elimination or adequate management of secondary causes, pharmacologic therapy may be required. Several agents have been reported to improve MS-related fatigue; however, only three have been investigated in controlled trials. Amantadine has been studied in several small controlled trials, and appears to be effective in one quarter to one third of those with mild-to-moderate fatigue. It has shown efficacy on a number of scales, including the Visual Analog Scale for Fatigue (VAS-F) and the MS-Specific Fatigue Scale (MS-FS). The central nervous system (CNS) stimulant pemoline has demonstrated limited benefit in clinical trials and is often poorly tolerated, especially in higher doses. Recently, the wake-promoting agent modafinil has been shown to significantly improve MS-related fatigue on a number of commonly used fatigue assessment scales, including the Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS).

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Fatigue after a first attack of suspected multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458517709348 ◽

2017 ◽

Vol 24 (7) ◽

pp. 974-981 ◽

Cited By ~ 3

Author(s):

Roos M van der Vuurst de Vries ◽

Jan JA van den Dorpel ◽

Julia Y Mescheriakova ◽

Tessel F Runia ◽

Naghmeh Jafari ◽

...

Keyword(s):

Multiple Sclerosis ◽

Depression Scale ◽

Common Symptom ◽

Disability Status ◽

Definite Multiple Sclerosis ◽

Fatigue Severity ◽

Clinically Definite Multiple Sclerosis ◽

In Cis

Background: Fatigue is reported by more than 75% of multiple sclerosis (MS) patients. In an earlier study, we showed that fatigue is not only a common symptom in patients at time of clinically isolated syndrome (CIS; fatigued 46%) but also predicts subsequent diagnosis of clinically definite multiple sclerosis (CDMS). The course of fatigue after CIS is unknown. Objective: We aimed to explore the long-term course of fatigue after CIS. Methods: In this study, 235 CIS patients, aged 18–50 years, were prospectively followed. Patients filled in the Krupp’s Fatigue Severity Scale (FSS) and the Hospital Anxiety and Depression Scale (HADS) at baseline and annually. After reaching CDMS diagnosis, Expanded Disability Status Scale (EDSS) was obtained annually. Mixed-effects models were used to analyse longitudinal FSS measurements. Results: Fatigue at baseline was an independent predictor for CDMS diagnosis (hazard ratio (HR): 2.6, 95% confidence interval (CI): 1.6–4.4). The evolution of FSS was the same in CIS patients who remained monophasic and patients who were diagnosed with CDMS during follow-up. However, FSS increased by 0.86 units after reaching CDMS diagnosis ( p = 0.01). After this increase, the FSS course remained unaltered ( p = 0.44). Conclusion: Fatigue, which is often present at time of CIS, probably persists over time and increases after a second attack.

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Portable Tracked Ultrasound System to Monitor Spinal Curvature

Inquiry@Queen's Undergraduate Research Conference Proceedings ◽

10.24908/iqurcp.9978 ◽

2018 ◽

Author(s):

Maggie Hess

Keyword(s):

Three Dimensional ◽

Spinal Curvature ◽

Ultrasound Probe ◽

Current Standard ◽

X Ray ◽

Reduce Radiation Exposure ◽

Promising Tool ◽

Tracked Ultrasound ◽

Curvature Measurements ◽

Risk Of Cancer

ntroduction: Adolescent idiopathic scoliosis (AIS) is the most frequent spinal deformation. It is assessed by frequent x-ray imaging, exposing patients to frequent radiation, increasing the risk of cancer. Tracked ultrasound imaging produce a three-dimensional visual of the spine without risk. We proposed using an optically tracked handheld USB Interson ultrasound probe, which is much less expensive than the current standard ultrasounds. Methods: A practical setup was developed for scoliosis monitoring. Reference markers were on the patient’s shoulder and the wall to account for patient motion, and simulate the plane of the x-ray detector to allow future comparisons. The optical tracker tracked the markers and ultrasound probe. This was compared to the electromagnetically tracked non-portable Ultrasonix ultrasound. Scanning captured the thoracic and lumbar regions. A three-dimensional image was composited by stacking a series of two-dimensional ultrasound slices in their tracked physical positions. To compare the two-ultrasound setups and ensure the ease of identification, a novice attempted to manually identify transverse processes. These were compared to see if all transverse processes scanned could be marked from both ultrasound setups. Two clinical experts then confirmed the markings were anatomically correct. Results and Conclusions: In all scans 100% of the transverse processes scanned (n = 51) were identified in Interson and Ultrasonix images. Curvatures measured using the Ultrasonix method have been previously validated to curvature measurements from x-ray images. Thus the 100% correspondence of the Interson and Ultrasonix setups indicates this inexpensive method is a promising tool to reduce radiation exposure during scoliosis monitoring.

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Structural and Antigenic Definition of Hepatitis C Virus E2 Glycoprotein Epitopes Targeted by Monoclonal Antibodies

Clinical and Developmental Immunology ◽

10.1155/2013/450963 ◽

2013 ◽

Vol 2013 ◽

pp. 1-12 ◽

Cited By ~ 30

Author(s):

Giuseppe Sautto ◽

Alexander W. Tarr ◽

Nicasio Mancini ◽

Massimo Clementi

Keyword(s):

Immune Response ◽

Monoclonal Antibodies ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Structural Characteristics ◽

Standard Of Care ◽

Surface Glycoprotein ◽

Current Standard ◽

Humoral Immune ◽

Promising Tool

Hepatitis C virus (HCV) is the major cause of chronic liver disease as well as the major indication for liver transplantation worldwide. Current standard of care is not completely effective, not administrable in grafted patients, and burdened by several side effects. This incomplete effectiveness is mainly due to the high propensity of the virus to continually mutate under the selective pressure exerted by the host immune response as well as currently administered antiviral drugs. The E2 envelope surface glycoprotein of HCV (HCV/E2) is the main target of the host humoral immune response and for this reason one of the major variable viral proteins. However, broadly cross-neutralizing monoclonal antibodies (mAbs) directed against HCV/E2 represent a promising tool for the study of virus-host interplay as well as for the development of effective prophylactic and therapeutic approaches. In the last few years many anti-HCV/E2 mAbs have been evaluated in preclinical and clinical trials as possible candidate antivirals, particularly for administration in pre- and post-transplant settings. In this review we summarize the antigenic and structural characteristics of HCV/E2 determined through the use of anti-HCV/E2 mAbs, which, given the absence of a crystal structure of this glycoprotein, represent currently the best tool available.

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Fatigue in Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis: Analysis from a Longitudinal Observation Cohort

The Journal of Rheumatology ◽

10.3899/jrheum.150463 ◽

2015 ◽

Vol 42 (12) ◽

pp. 2354-2360 ◽

Cited By ~ 20

Author(s):

Mohamed Bedaiwi ◽

Ismail Sari ◽

Arane Thavaneswaran ◽

Renise Ayearst ◽

Nigil Haroon ◽

...

Keyword(s):

Ankylosing Spondylitis ◽

Disease Activity ◽

Axial Spondyloarthritis ◽

Acute Phase Proteins ◽

Activity Index ◽

Health Assessment ◽

Disease Activity Index ◽

Common Symptom ◽

Severe Fatigue ◽

Fatigue Severity

Objective.In this study, we aimed to address the prevalence of fatigue, its associated factors, and the effect of tumor necrosis factor inhibitors (TNFi) on this subgroup of patients in a large axial spondyloarthritis (axSpA) cohort.Methods.The study included 681 patients [ankylosing spondylitis (AS) and nonradiographic axSpA (nr-axSpA)]. The Fatigue Severity Scale (FSS) and the Bath AS Disease Activity Index question 1 (BASDAI Q1) indices were used for fatigue assessment. Severe fatigue was defined as an FSS ≥ 4 or a BASDAI Q1 ≥ 5. Disease activity, function, and quality of life (QoL) measures were recorded. Patients who had been treated with TNFi were identified, and baseline and followup data were analyzed.Results.Of the cohort, 67.3% had severe fatigue, and the prevalence was similar between AS (67.2%) and nr-axSpA (68.2%). Severely fatigued patients tended to have higher disease activity scores, increased acute-phase proteins, and decreased QoL measures. TNFi therapy was associated with improvement in disease activity, and although this treatment led to significantly decreased fatigue scores, this reduction was not optimal in the majority of patients with 80% continuing to have severe fatigue according to their posttreatment scores. Health Assessment Questionnaire, mean scores of BASDAI Q5 and Q6, and BASDAI enthesitis were independent predictors of fatigue severity.Conclusion.Fatigue is a common symptom in axSpA, and the burden of fatigue among patients with nr-axSpA is similar to that seen in AS. While biologics are effective in improving disease activity, their effect on fatigue is more limited. In axSpA, fatigue remains unresponsive to TNFi in nearly 80% of patients.

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Fatigue Is Associated with Poor Sleep in People with Multiple Sclerosis and Cognitive Impairment

Multiple Sclerosis International ◽

10.1155/2014/872732 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

Michelle H. Cameron ◽

Vanessa Peterson ◽

Eilis A. Boudreau ◽

Ashley Downs ◽

Jesus Lovera ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Sleep Quality ◽

Cross Sectional Study ◽

Poor Sleep ◽

Common Symptom ◽

Cross Sectional ◽

Impact Scale ◽

Quality Sleep ◽

Fatigue Severity

Background. Fatigue is the most common symptom in people with multiple sclerosis (MS). Poor sleep also occurs in this population.Objective. The objective of this study was to determine the relationship between fatigue and sleep quality in people with MS and cognitive impairment.Method. This cross-sectional study assessed relationships among fatigue, assessed with the Modified Fatigue Impact Scale (MFIS) and the Fatigue Severity Scale (FSS), sleep quality assessed with the Pittsburg Sleep Quality Index (PSQI), and demographics in 121 people with MS and cognitive impairment.Results. Fatigue was significantly correlated with poor sleep quality (MFIS:F=15.60,P<0.01; FSS:F=12.09,P<0.01). FSS scores were also significantly correlated with the PSQI subscore for daytime dysfunction and MFIS scores were significantly correlated with disability, age, and the PSQI subscores for sleep quality, sleep duration, and daytime dysfunction.Conclusions. This study demonstrates a relationship between fatigue and sleep quality in individuals with MS and cognitive impairment.

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Detecting and Tracking the Positions of Wild Ungulates Using Sound Recordings

Sensors ◽

10.3390/s21030866 ◽

2021 ◽

Vol 21 (3) ◽

pp. 866

Author(s):

Salem Ibrahim Salem ◽

Kazuhiko Fujisao ◽

Masayasu Maki ◽

Tadanobu Okumura ◽

Kazuo Oki

Keyword(s):

Time Lag ◽

Internal Clock ◽

Automated System ◽

Tree Cover ◽

Wild Ungulates ◽

Sound Recordings ◽

Promising Tool ◽

Gps Satellites ◽

In The Wild ◽

Time Drift

Monitoring wild ungulates such as deer is a highly challenging issue faced by wildlife managers. Wild ungulates are increasing in number worldwide, causing damage to ecosystems. For effective management, the precise estimation of their population size and habitat is essential. Conventional methods used to estimate the population density of wild ungulates, such as the light census survey, are time-consuming with low accuracy and difficult to implement in harsh environments like muddy wetlands. On the other hand, unmanned aerial vehicles are difficult to use in areas with dense tree cover. Although the passive acoustic monitoring of animal sounds is commonly used to evaluate their diversity, the potential for detecting animal positions from their sound has not been sufficiently investigated. This study introduces a new technique for detecting and tracking deer position in the wild using sound recordings. The technique relies on the time lag among three recorders to estimate the position. A sound recording system was also developed to overcome the time drift problem in the internal clock of recorders, by receiving time information from GPS satellites. Determining deer position enables the elimination of repetitive calls from the same deer, thus providing a promising tool to track deer movement. The validation results revealed that the proposed technique can provide reasonable accuracy for the experimental and natural environment. The identification of deer calls in Oze National Park over a period of two hours emphasizes the great potential of the proposed technique to detect repetitive deer calls, and track deer movement. Hence, the technique is the first step toward designing an automated system for estimating the population of deer or other vocal animals using sound recordings.

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Behavioural and life-history responses of mosquitofish to biologically inspired and interactive robotic predators

Journal of The Royal Society Interface ◽

10.1098/rsif.2019.0359 ◽

2019 ◽

Vol 16 (158) ◽

pp. 20190359 ◽

Cited By ~ 11

Author(s):

Giovanni Polverino ◽

Mert Karakaya ◽

Chiara Spinello ◽

Vrishin R. Soman ◽

Maurizio Porfiri

Keyword(s):

Life History ◽

Causal Link ◽

The Body ◽

Energy Reserves ◽

Biologically Inspired ◽

Information Theoretic ◽

Antipredator Response ◽

Promising Tool ◽

In The Wild ◽

Open Question

Invasive alien species threaten biodiversity worldwide and contribute to biotic homogenization, especially in freshwaters, where the ability of native animals to disperse is limited. Robotics may offer a promising tool to address this compelling problem, but whether and how invasive species can be negatively affected by robotic stimuli is an open question. Here, we explore the possibility of modulating behavioural and life-history responses of mosquitofish by varying the degree of biomimicry of a robotic predator, whose appearance and locomotion are inspired by natural mosquitofish predators. Our results support the prediction that real-time interactions at varying swimming speeds evoke a more robust antipredator response in mosquitofish than simpler movement patterns by the robot, especially in individuals with better body conditions that are less prone to take risks. Through an information-theoretic analysis of animal–robot interactions, we offer evidence in favour of a causal link between the motion of the robotic predator and a fish antipredator response. Remarkably, we observe that even a brief exposure to the robotic predator of 15 min per week is sufficient to erode energy reserves and compromise the body condition of mosquitofish, opening the door for future endeavours to control mosquitofish in the wild.

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Is cellular energy monitoring more responsive to hypoxia than pulse oximetry?

Sleep And Breathing ◽

10.1007/s11325-020-02104-2 ◽

2020 ◽

Vol 24 (4) ◽

pp. 1633-1643

Author(s):

Guy M. Hatch ◽

Liza Ashbrook ◽

Aric A. Prather ◽

Andrew D. Krystal

Keyword(s):

Pulse Oximetry ◽

Oxygen Supply ◽

Physical Exertion ◽

Current Standard ◽

Blood Oxygen Saturation ◽

Energy Monitoring ◽

Cellular Energy ◽

Promising Tool ◽

Arterial Blood ◽

Obstructive Sleep

Abstract Purpose Pulse oximetry is the current standard for detecting drops in arterial blood oxygen saturation (SpO2) associated with obstructive sleep apnea and hypopnea events in polysomnographic (PSG) testing. However, cellular energy monitoring (CE monitoring), a measure related to cellular hypoxia in the skin, is likely to be more responsive to inadequate breathing during sleep because during hypoxic challenge, such as occurs during apneic events, regulatory mechanisms restrict blood flow to the skin to preferentially maintain SpO2 for more vital organs. We carried out initial proof of concept testing to determine if CE monitoring has promise for being more responsive to hypoxic challenge occurring during sleep-disordered breathing (SDB) than pulse oximetry. Methods We assessed both CE monitoring and pulse oximetry in a series of conditions which affect oxygen supply: (1) breathing nitrogen or 100% oxygen, (2) physical exertion, and (3) studying a night of sleep in an individual known to be a loud snorer. We also present the results of a preliminary study comparing CE monitoring to pulse oximetry in eight individuals undergoing standard clinical overnight polysomnography for suspected SDB. Results CE monitoring is responsive to changes in cellular oxygen supply to the skin and detects hypoxia during SDB events that is not detected by pulse oximetry. Conclusion CE monitoring is a promising tool for identifying pathology at the mild end of the SDB spectrum.

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