Initial pilot testing of a smartphone app for detection of chemotherapy-induced peripheral neuropathy.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 176-176
Author(s):  
Daniel Louis Hertz ◽  
Ciao-Sin Chelsea Chen ◽  
Judith Louis Kim ◽  
Harsha Guntupalli ◽  
Michael Dorsch ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Principal Component ◽  
Common Side Effect ◽  
Smartphone App ◽  
Dominant Hand ◽  
Balance Test ◽  
Patient Reported ◽  
Functional Assessments ◽  
Specialized Equipment ◽  
The Difference

176 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect that manifests in the hands or feet primarily as numbness or tingling but can also have motor or painful components. CIPN monitoring is typically conducted by patients self-reporting symptoms during appointments or via questionnaires. Objective CIPN testing may improve early detection but is not typical during treatment, perhaps due to the need for specialized equipment and personnel. The objective of this pilot study was to conduct initial testing of a smartphone app that collects patient-reported and objective CIPN data. Methods: NeuroDetect V1.0 (available in iOS app store) includes a patient-reported CIPN questionnaire (EORTC CIPN20) and two functional assessments available within ResearchKit, the Gat and Balance and 9-Hole Peg tests. Patients who had completed neurotoxic chemotherapy were enrolled to complete NeuroDetect assessments one time. Study participants were classified as CIPN cases if they answered ≥ 3 for at least one of the first four CIPN20 questions, which ask about numbness or tingling in the hands or feet on a 1-4 scale. User acceleration data features were extracted with two open source tools, mhealthtools and pdkit. The results of the functional assessments were compared between CIPN cases and controls in principal component analysis and partial least squares discriminant analysis. Results: Twenty-four patients who had completed neurotoxic chemotherapy enrolled and completed the NeuroDetect assessments. Integration across all 87 features measured in the gait and balance test explained 42% of the difference between CIPN cases (n = 14) and controls (n = 10) and 9 individual features were significantly different between cases and controls (all p < 0.05). In the 9-hole Peg Test, hand speed explained 77% of the difference between CIPN cases and controls. CIPN cases took longer to complete the 9-hole peg test though the difference was not statistically significant (dominant hand mean 407.3 vs. 406.2 ms, p = 0.075). Conclusions: App-based functional assessment may detect evidence of CIPN. We are developing additional CIPN functional assessments for NeuroDetect V2.0 to test CIPN detection in a longitudinal study of patients undergoing neurotoxic chemotherapy.

scholarly journals Chemotherapy-induced peripheral neuropathy detection via smartphone app in a cross-sectional pilot study (Preprint)

2021 ◽  
Author(s):  
Ciao-Sin Chen ◽  
Judy Kim ◽  
Harsha Guntupalli ◽  
Noemi Garg ◽  
Reshma Jagsi ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Pilot Study ◽  
Clinical Care ◽  
Objective Assessment ◽  
Self Report ◽  
Smartphone App ◽  
Cross Sectional ◽  
Patient Reported ◽  
Functional Assessments ◽  
Hands And Feet

BACKGROUND Severe chemotherapy-induced peripheral neuropathy (CIPN) can cause long-term dysfunction of the hands and feet, interfere with activities of daily living, and diminish quality of life. Monitoring to identify CIPN before it progresses to life-altering severity relies on patients self-reporting subjective symptoms to their clinical team. Objective assessment is not a standard component of CIPN monitoring due to the requirement for specially trained healthcare professionals and equipment. Smartphone apps have the potential to conveniently collect both subjective and objective CIPN data directly from patients, which could improve CIPN monitoring. OBJECTIVE The objective of this cross-sectional pilot study was to assess the feasibility of functional CIPN assessment via smartphone app. METHODS Twenty-six patients who had completed neurotoxic chemotherapy were enrolled and classified as CIPN cases (n=16) or controls (n=10) based on self-report symptoms. All participants completed CIPN assessments within the NeuroDetect app a single time including patient-reported surveys (CIPN20 and PRO-CTCAE) and functional assessments (Gait and Balance and 9 Hole Peg Test). RESULTS Exploratory comparisons between CIPN cases and controls indicate CIPN cases had shorter step length (P=.003), unique swaying acceleration patterns during a walking task, and shorter hand moving distance during a manual dexterity task. CONCLUSIONS Our results confirm that remote CIPN assessment via a smartphone app is feasible and suggest that functional data may be indicative of CIPN manifestations in the hands and feet. Additional work is needed to determine which functional assessments are most indicative of CIPN and could be used for CIPN monitoring within clinical care.

scholarly journals Gait and Balance Function Improves After 10 Weeks of Using a Wearable Sensory Neuroprosthesis in Persons with Peripheral Neuropathy and High Fall Risk - the walk2Wellness Trial

2020 ◽  
Author(s):  
Lars I E Oddsson ◽  
Teresa Bisson ◽  
Helen S Cohen ◽  
Laura Jacobs ◽  
Mohammad Khoshnoodi ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Gait Speed ◽  
Fall Risk ◽  
Patient Reported Outcomes ◽  
Foot Pressure ◽  
Balance Test ◽  
Tactile Stimuli ◽  
Patient Reported ◽  
Abc Scale ◽  
Balance Problems

Background: Patients with sensory peripheral neuropathy (PN) commonly present with gait and balance problems increasing their risk of falls. The multi-site walk2Wellness trial investigates effects of long-term, home-based daily use of a wearable lower limb sensory neuroprosthesis on gait function, balance, quality of life and fall rates in a cohort of PN patients. The device (Walkasins®, RxFunction Inc., MN, USA) is designed to replace lost nerve function related to foot pressure sensation by providing directional tactile cues around the ankle reflecting foot pressure measurements during standing and walking activities. We hypothesized that previously shown short-term in-clinic improvements in gait and balance would be sustained after 10 weeks of use. Methods: Participants had a PN diagnosis with loss of plantar sensation associated with gait and balance problems, a Functional Gait Assessment (FGA) score <23 (cut-off for high fall risk), and ability to sense Leg Unit tactile stimuli. Clinical outcomes included FGA, Gait Speed, Timed Up&Go (TUG) and Four-Stage Balance Test. Patient-reported outcomes included Activities-Specific Balance Confidence (ABC) scale, Vestibular Disorders Activities of Daily Living Scale (VADL), PROMIS participation and satisfaction scores, pain rating, and falls. Evaluations were performed at baseline visit and after 2, 6, and 10 weeks. Subjects were not made aware of any changes in outcomes and no additional balance interventions were allowed. Results: Forty-five participants of 52 enrolled across four sites completed all in-clinic assessments. FGA scores improved from 15.0 at baseline to 19.1 at 10 weeks (p<0.000001), normal and fast gait speed from 0.86m/s to 0.95m/s (p<0.00005) and 1.24m/s to 1.33m/s (p<0.002), respectively, and TUG from 13.8s to 12.5s (p<0.012). Four-Stage Balance Test did not improve significantly. Several patient-reported outcomes were in normal range at baseline and remained largely unchanged. Interestingly, while FGA scores improved similarly across the baseline range, subjects with baseline ABC scores lower than 67% (cut-off for high fall risk) showed an increase in their ABC scores (from 49.9% to 59.3%, p<0.01), whereas subjects with baseline ABC scores above 67% showed a decrease (from 76.6% to 71.8%, p<0.019). Subjects who reported falls in the prior six months (n=25) showed a decrease in the number of fall-risk factors (from 5.1 to 4.3, p<0.023) as well as a decrease in fall rate from 13.8 to 7.4 falls/1000 days (p<0.014). Four subjects in the pre-study non-faller group (n=20) fell during the 10 weeks of the study. Conclusion: A wearable sensory neuroprosthesis may provide a new way to treat gait and balance problems and manage falls in high fall-risk patients with PN. Trial registration: ClinicalTrials.gov (#NCT03538756)

scholarly journals Improving Chemotherapy-Induced Peripheral Neuropathy in Patients with Breast or Colon Cancer after End of (Neo)adjuvant Therapy: Results from the Observational Study STEFANO

2021 ◽  
pp. 1-9
Author(s):  
Matthias Zaiss ◽  
Jens Uhlig ◽  
Mark-Oliver Zahn ◽  
Thomas Decker ◽  
Helmar C. Lehmann ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colon Cancer ◽  
Peripheral Neuropathy ◽  
Observational Study ◽  
Cancer Patients ◽  
Sensory Neuropathy ◽  
Common Side Effect ◽  
Motor Neuropathy ◽  
Breast Cancer Patients ◽  
Patient Reported

<b><i>Introduction:</i></b> Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect persisting after completion of neurotoxic chemotherapies. This observational study was designed to evaluate the effectiveness of the dietary supplement OnLife® (patented mixture of specific fatty acids and palmitoylethanolamide) in improving symptoms of CIPN in breast and colon cancer patients. <b><i>Methods:</i></b> Improvement of CIPN was evaluated in adult patients, previously treated with (neo)adjuvant paclitaxel- (breast cancer) or oxaliplatin-based (colon cancer) therapies, receiving OnLife® for 3 months after completion of chemotherapy. The primary endpoint was to compare the severity of peripheral sensory neuropathy (PSN) and peripheral motor neuropathy (PMN) before and at the end of OnLife® treatment. Secondary endpoints included the assessment of patient-reported quality of life and CIPN symptoms as assessed by questionnaires. <b><i>Results:</i></b> 146 patients (<i>n</i> = 75 breast cancer patients and <i>n</i> = 71 colon cancer patients) qualified for analysis; 31.1% and 37.5% of breast cancer patients had an improvement of PSN and PMN, respectively. In colon cancer patients, PSN and PMN improved in 16.9% and 20.0% of patients, respectively. According to patient-reported outcomes, 45.9% and 37.5% of patients with paclitaxel-induced PSN and PMN, and 23.9% and 22.0% of patients with oxaliplatin-induced PSN and PMN experienced a reduction of CIPN symptoms, respectively. <b><i>Conclusion:</i></b> OnLife® treatment confirmed to be beneficial in reducing CIPN severity and in limiting the progression of neuropathy, more markedly in paclitaxel-treated patients and also in patients with oxaliplatin-induced CIPN.

Multivariate micropollutants analysis in marine waters

1995 ◽  
Vol 32 (9-10) ◽  
pp. 341-348
Author(s):  
V. Librando ◽  
G. Magazzù ◽  
A. Puglisi
Keyword(s):  
Multivariate Data Analysis ◽  
Partial Least Squares Regression ◽  
Environmental Chemistry ◽  
Sampling Site ◽  
Principal Component ◽  
Least Squares Regression ◽  
Organic Micropollutants ◽  
Suspended Material ◽  
The Difference

The monitoring of water quality today provides a great quantity of data consisting of the values of the parameters measured as a function of time. In the marine environment, and especially in the suspended material, increasing importance is being given to the presence of organic micropollutants, particularly since some are known to be carcinogenic. As the number of measured parameters increases examining the data and their consequent interpretation becomes more difficult. To overcome such difficulties, numerous chemometric techniques have been introduced in environmental chemistry, such as Multivariate Data Analysis (MVDA), Principal Component Analysis (PCA) and Partial Least Squares Regression (PLSR). The use of the first technique in this work has been applied to the interpretation of the quality of Augusta bay, by measuring the concentration of numerous organic micropollutants, together with the classical water pollution parameters, in different sites and at different times. The MVDA has highlighted the difference between various sampling sites whose data were initially thought to be similar. Furthermore, it has allowed a choice of more significant parameters for future monitoring and more suitable sampling site locations.

scholarly journals Clinical evaluation of manual stress testing, stress ultrasound and 3D stress MRI in chronic mechanical ankle instability

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Markus Wenning ◽  
Dominic Gehring ◽  
Thomas Lange ◽  
David Fuerst-Meroth ◽  
Paul Streicher ◽  
...  
Keyword(s):  
Stress Testing ◽  
Ankle Instability ◽  
Tilt Test ◽  
Diagnostic Study ◽  
Mechanical Instability ◽  
Subjective Character ◽  
Balance Test ◽  
Research And Practice ◽  
Cutoff Values ◽  
Patient Reported

Abstract Background Chronic ankle instability (CAI) arises from the two etiological factors of functional (FAI) and mechanical ankle instability (MAI). To distinguish the contributions of the two etiologies, it is necessary to quantitively assess functional and mechanical deficits. Validated and reproducible assessment of mechanical instability remains a challenge in current research and practice. Physical examination, stress sonography and a novel 3D stress MRI have been used, while stress radiography has been called into question and arthrometry is limited to research purposes. The interaction of these primarily mechanical measurements with the functional and subjective components of CAI are subject to debate. The aim of this study was the evaluation of the clinical and biomechanical preferences of the three different methods in the diagnosis of MAI. Methods In this cross-sectional diagnostic study, we compared three different diagnostic approaches to mechanical ankle instability: (1) manual stress testing (anterior drawer test [ADT] and talar tilt test [TTT]), (2) stress sonography and (3) 3D stress MRI (3SAM) The latter includes quantification of 3D cartilage contact area (CCA) in plantarflexion-supination compared to neutral-null position. We applied these measurements to a cohort of patients suffering from chronic mechanical ankle instability (n = 25) to a matched cohort of healthy controls (n = 25). Perceived instability was assessed using the Cumberland Ankle Instability Tool (CAIT) and Forgotten Joint Score (FJS). Functional deficits were measured using postural sway and the y-Balance test. Results Significant differences between the two groups (single-factor “group” ANOVA, p < 0.05) were found in all of the mechanical assessments with strong effect sizes. Spearman’s correlations were strong for CAIT and manual stress testing (TTT rho = − 0.83, ADT rho = − 0.81), 3D stress MRI (rho = − 0.53) and stress sonography (TTT rho = − 0.48, ADT rho = − 0.44). Furthermore, the correlation between manual stress testing and CCA in the fibulotalar articulation (CCAFT) was strong (rho = 0.54) and the correlations to stress sonography were moderate (ADT rho = 0.47 and TTT rho = 0.43). The calculation of cutoff values revealed a distance of > 5.4 mm increase in ligament length during stress sonography (sensitivity 0.92, specificity 0.6) and > 43% loss of articulating surface in the fibulotalar joint (CCAFT in supination-plantarflexion using 3SAM, sensitivity 0.71, specificity 0.8) as potential cutoff values for diagnosing MAI. Conclusions Manual stress testing showed to be a valuable method of identifying mechanical ankle instability. However, due to is subjective character it may overvalue patient-reported instability as a factor which explains the high correlation to the CAIT-score, but this may also reduce its value in diagnosing the isolated mechanical quality of the joint. Thus, there is a persisting need for objective and reproducible alternatives focusing on MAI. According to our results, 3D stress MRI and stress sonography represent valuable alternatives and may be used to quantitively assess mechanical ankle instability in research and practice. Trial registration German Registry of Clinical Trials # DRKS00016356, registered on 05/11/2019.

scholarly journals Distribution and Severity of Placental Lesions Caused by the Chlamydia abortus 1B Vaccine Strain in Vaccinated Ewes

Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 543
Author(s):  
Sergio Gastón Caspe ◽  
Javier Palarea-Albaladejo ◽  
Clare Underwood ◽  
Morag Livingstone ◽  
Sean Ranjan Wattegedera ◽  
...  
Keyword(s):  
Disease Outbreaks ◽  
Principal Component ◽  
Placental Pathology ◽  
Wild Type ◽  
Cell Infiltrate ◽  
Chlamydia Abortus ◽  
Vaccine Type ◽  
The Difference ◽  
Enzootic Abortion Of Ewes

Chlamydia abortus infects livestock species worldwide and is the cause of enzootic abortion of ewes (EAE). In Europe, control of the disease is achieved using a live vaccine based on C. abortus 1B strain. Although the vaccine has been useful for controlling disease outbreaks, abortion events due to the vaccine have been reported. Recently, placental pathology resulting from a vaccine type strain (vt) infection has been reported and shown to be similar to that resulting from a natural wild-type (wt) infection. The aim of this study was to extend these observations by comparing the distribution and severity of the lesions, the composition of the predominating cell infiltrate, the amount of bacteria present and the role of the blood supply in infection. A novel system for grading the histological and pathological features present was developed and the resulting multi-parameter data were statistically transformed for exploration and visualisation through a tailored principal component analysis (PCA) to evaluate the difference between them. The analysis provided no evidence of meaningful differences between vt and wt strains in terms of the measured pathological parameters. The study also contributes a novel methodology for analysing the progression of infection in the placenta for other abortifacient pathogens.

scholarly journals Possibility of Human Gender Recognition Using Raman Spectra of Teeth

Molecules ◽  
2021 ◽  
Vol 26 (13) ◽  
pp. 3983
Author(s):  
Ozren Gamulin ◽  
Marko Škrabić ◽  
Kristina Serec ◽  
Matej Par ◽  
Marija Baković ◽  
...  
Keyword(s):  
Raman Spectra ◽  
Principal Component ◽  
Support Vector ◽  
Gender Recognition ◽  
Proof Of Concept ◽  
Male And Female ◽  
Tooth Type ◽  
Tooth Apex ◽  
The Difference

Gender determination of the human remains can be very challenging, especially in the case of incomplete ones. Herein, we report a proof-of-concept experiment where the possibility of gender recognition using Raman spectroscopy of teeth is investigated. Raman spectra were recorded from male and female molars and premolars on two distinct sites, tooth apex and anatomical neck. Recorded spectra were sorted into suitable datasets and initially analyzed with principal component analysis, which showed a distinction between spectra of male and female teeth. Then, reduced datasets with scores of the first 20 principal components were formed and two classification algorithms, support vector machine and artificial neural networks, were applied to form classification models for gender recognition. The obtained results showed that gender recognition with Raman spectra of teeth is possible but strongly depends both on the tooth type and spectrum recording site. The difference in classification accuracy between different tooth types and recording sites are discussed in terms of the molecular structure difference caused by the influence of masticatory loading or gender-dependent life events.

scholarly journals Difference in patient-reported outcomes of various patellar component designs in total knee arthroplasty: A randomized clinical study

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199606
Author(s):  
Takeshi Mochizuki ◽  
Koichiro Yano ◽  
Katsunori Ikari ◽  
Ken Okazaki
Keyword(s):  
Knee Osteoarthritis ◽  
Clinical Effects ◽  
Patellar Component ◽  
American College Of Rheumatology ◽  
Randomized Clinical Study ◽  
Component Design ◽  
Patient Reported ◽  
Total Knee ◽  
The Difference ◽  
And Function

Purpose: This study investigated the clinical effects of different patellar components without being affected by the femoral component design in total knee arthritis (TKA) for patients with knee osteoarthritis (OA). Methods: In total, 48 patients with OA who met the criteria of the American College of Rheumatology for OA were enrolled and randomly assigned in a 1:1 ratio to two groups according to the usage of patellar component design for TKA (medialized dome type [dome group] or medialized anatomic type [anatomic group]). To evaluate the clinical outcomes for TKA, knee range of motion (ROM), pain intensity of 0–100 mm visual analog scale (pain VAS), and the Japanese Knee Osteoarthritis Measure (JKOM) score were obtained at baseline and year 1. Results: The difference in knee ROM, pain VAS, or total JKOM score at year 1 was not significant between the dome and anatomic groups ( p = 0.398, 0.733 and 0.536, respectively). Moreover, similar results were obtained for changes in knee ROM, pain VAS, or total JKOM scores from baseline. In both groups, the pain VAS and total JKOM scores were significantly improved at year 1. Conclusion: Both dome and anatomic groups in TKA are significantly effective for pain and function using the JKOM score. However, their efficacy did not differ, according to the JKOM score. Results of this study are rare information focusing on the patellar component design and provide one of the insights into the TKA clinical management.

Objective and Subjective Outcomes in Patients with Hearing Aids: A Cross-Sectional, Comparative, Associational Study

2021 ◽  
pp. 1-9
Author(s):  
Xunyi Wang ◽  
Yun Zheng ◽  
Gang Li ◽  
Jingzhe Lu ◽  
Yan Yin
Keyword(s):  
Hearing Aids ◽  
Patient Reported Outcomes ◽  
Cross Sectional ◽  
Patient Reported ◽  
Objective Tests ◽  
The Difference ◽  
Potential Factors ◽  
Positive Correlations ◽  
The Relationship ◽  
Subjective Outcomes

<b><i>Introduction:</i></b> Outcome assessment for hearing aids (HAs) is an essential part of HA fitting and validation. There is no consensus about the best or standard approach for evaluating HA outcomes. And, the relationship between objective and subjective measures is ambiguous. This study aimed to determine the outcomes after HA fitting, explore correlations between subjective benefit and acoustic gain improvement as well as objective audiologic tests, and investigate several variables that may improve patients’ perceived benefits. <b><i>Methods:</i></b> Eighty adults with bilateral symmetrical hearing loss using HAs for at least 1 month were included in this study. All subjects completed the pure tone average (PTA) threshold and word recognition score (WRS) tests in unaided and aided conditions. We also administered the Chinese version of International Outcome Inventory for Hearing Aids (IOI-HA), to measure participants’ subjective benefits. Objective HA benefit (acoustic gain improvement) was defined as the difference in thresholds or scores between aided and unaided conditions indicated with ΔPTA and ΔWRS. Thus, patients’ baseline hearing levels were taken into account. Correlations were assessed among objective audiologic tests (PTA and WRS), acoustic gain improvement (ΔPTA and ΔWRS), multiple potential factors, and IOI-HA overall scores. <b><i>Results:</i></b> PTA decreased significantly, but WRS did not increase when aided listening was compared to unaided listening. Negative correlations between PTAs and IOI-HA scores were significant but weak (<i>r</i> = −0.370 and <i>r</i> = −0.393, all <i>p</i> &#x3c; 0.05). Significant weak positive correlations were found between WRSs and IOI-HA (<i>r</i> = 0.386 and <i>r</i> = 0.309, all <i>p</i> &#x3c; 0.05). However, there was no correlation among ΔPTA, ΔWRS, and IOI-HA (<i>r</i> = 0.056 and <i>r</i> = −0.086, all <i>p</i> &#x3e; 0.05). Moreover, 2 nonaudiological factors (age and daily use time) were significantly correlated with IOI-HA (<i>r</i> = −0.269 and <i>r</i> = 0.242, all <i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> Correlations among objective audiologic tests, acoustic gain, and subjective patient-reported outcomes were weak or absent. Subjective questionnaires and objective tests do not reflect the same hearing capability. Therefore, it is advisable to evaluate both objective and subjective outcomes when analyzing HA benefits on a regular basis and pay equal attention to nonaudiological and audiological factors.

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