scholarly journals Prospective Evaluation of Health Care Provider and Patient Assessments in Chemotherapy Induced Peripheral Neurotoxicity

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012300
Author(s):  
Paola Alberti ◽  
Davide Paolo Bernasconi ◽  
David R. Cornblath ◽  
Ingemar Sergio Jose Merkies ◽  
Susanna B Park ◽  
...  
Keyword(s):  
Neurological Status ◽  
Change Score ◽  
Class Iii ◽  
Peripheral Neurotoxicity ◽  
Johns Hopkins University ◽  
Clinically Important Deterioration ◽  
Patient Assessments ◽  
The Mean ◽  
The Difference

OBJECTIVEThere is not agreement on the “gold standard” for detection and grading of Chemotherapy Induced Peripheral Neurotoxicity (CIPN) in clinical trials. We performed an observational prospective study to assess and compare both patient-based and physician-based methods.METHODSConsecutive patients, aged 18 years or older, candidates for neurotoxic chemotherapy were enrolled in US/EU/Australia. A trained investigator performed physician-based scales (Total Neuropathy Score clinical [©Johns Hopkins University; TNSc], then used to calculate TNS nurse [TNSn]) and supervised the patient-completed questionnaire (FACT/GOG-NTX©). Evaluations were performed before and at the end of chemotherapy. On participants without neuropathy at baseline we assessed the association between TNSc, TNSn and FACT/GOG-NTX. Considering a previously established Minimal Clinically Important Difference (MCID) for FACT/GOG-NTX, we identified participants with and without a clinically important deterioration according to this scale. Then, we calculated the MCID for TNSc and TNSn as the difference in the mean change score of these scales between the two groups.RESULTSData from 254 participants were available, 180 (71%) had normal neurological status at baseline. At the end of the study, 88% of participants developed any grade of neuropathy. TNSc, TNSn and FACT/GOG-NTX showed good responsiveness (standardized mean change from baseline to end of chemotherapy >1 for all scales). On the 153 participants without neuropathy at baseline and treated with a known neurotoxic chemotherapy regimen we verified a moderate correlation in both TNSc and TNSn scores with FACT/GOG-NTX (Spearman correlation index r=0.6). On the same sample, considering as clinically important a change in the FACT/GOG-NTX score of at least 3.3 points, the MCID was 3.7 for TNSc and 2.8 for the TNSn.CONCLUSIONSMCID for TNSc and TNSn have been calculated, and the TNSn can be considered a reliable alternative objective clinical assessment if a more extended neurological examination is not possible. Moreover, the FACT/GOG-NTX score can be reduced to 7 items and these items correlate well with the TNSc and TNSn.CLASSIFICATION OF EVIDENCEThis study provides Class III evidence that a patient-completed questionnaire and nurse-assessed scale correlate with a physician-assessed scale.

scholarly journals Efficient feature for classification of eye movements using electrooculography signals

2016 ◽  
Vol 20 (suppl. 2) ◽  
pp. 563-572 ◽  
Author(s):  
Pornchai Phukpattaranont ◽  
Siriwadee Aungsakul ◽  
Angkoon Phinyomark ◽  
Chusak Limsakul
Keyword(s):  
Eye Movements ◽  
Computer Interface ◽  
Human Computer Interface ◽  
Scatter Plot ◽  
Mean Values ◽  
Maximum Peak ◽  
The Mean ◽  
The Difference ◽  
Feature Values

Electrooculography (EOG) signal is widely and successfully used to detect activities of human eye. The advantages of the EOG-based interface over other conventional interfaces have been presented in the last two decades; however, due to a lot of information in EOG signals, the extraction of useful features should be done before the classification task. In this study, an efficient feature extracted from two directional EOG signals: vertical and horizontal signals has been presented and evaluated. There are the maximum peak and valley amplitude values, the maximum peak and valley position values, and slope, which are derived from both vertical and horizontal signals. In the experiments, EOG signals obtained from five healthy subjects with ten directional eye movements were employed: up, down, right, left, up-right, up-left, down-right down-left clockwise and counterclockwise. The mean feature values and their standard deviations have been reported. The difference between the mean values of the proposed feature from different eye movements can be clearly seen. Using the scatter plot, the differences in features can be also clearly observed. Results show that classification accuracy can approach 100% with a simple distinction feature rule. The proposed features can be useful for various advanced human-computer interface applications in future researches.

Cutting, Impingement, Contact, Endurance, Flexibility, and Asymmetric/Overhead Sports: Is There a Difference in Return-to-Sport Rate After Arthroscopic Femoroacetabular Impingement Surgery? A Systematic Review and Meta-analysis

2020 ◽  
pp. 036354652095044
Author(s):  
Ioanna K. Bolia ◽  
Hansel Ihn ◽  
Hyunwoo P. Kang ◽  
Cory K. Mayfield ◽  
Karen K. Briggs ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Return To Sport ◽  
Rate Of Return ◽  
Intraoperative Procedures ◽  
Overhead Athletes ◽  
The Mean ◽  
The Difference

Background: Previous studies have established a classification of sports based on hip mechanics: cutting, impingement, contact, endurance, flexibility, and asymmetric/overhead. No previous review has compared the outcomes of hip arthroscopy for femoroacetabular impingement syndrome (FAIS) using this classification. Purpose: To determine whether the rate of return to sport differs among cutting, impingement, contact, endurance, flexibility, and asymmetric/overhead athletes who undergo hip arthroscopy for FAIS. We also aimed to identify differences in patient characteristics, intraoperative procedures performed, and time to return to play among the 6 sport categories. Study Design: Systematic review and meta-analysis. Methods: Three electronic databases were searched for eligible articles. Two reviewers independently screened the titles, abstract, and full-text articles using prespecified criteria. Eligible articles were those that reported the rate of return to sport (defined by the number of hips) after hip arthroscopy for FAIS in athletes of all levels. Data collected were patient age, sex, body mass index, type of sport, rate and time to return to sport, and intraoperative procedures performed. A mixed effects model was used for meta-analysis. Results: A total of 29 articles and 1426 hip arthroscopy cases were analyzed with 185 cutting, 258 impingement, 304 contact, 207 endurance, 116 flexibility, and 356 asymmetric/overhead athletes. The mean age was similar among the 6 subgroups ( P = .532), but the proportion of female athletes was significantly higher in flexibility, endurance, and asymmetric/overhead sports as compared with impingement and contact athletes. Flexibility athletes had the highest rate of return to sport after hip arthroscopy for FAIS (94.8%), whereas contact athletes had the lowest rate (88%). The longest mean ± SD time (8.5 ± 1.9 months) to return to sport was reported in cutting sports, while endurance athletes returned faster than the rest (5.4 ± 2.6 months). The difference in rate and time to return to sport, as well as the intraoperative procedure performed, did not reach statistical significance among the 6 subgroups. There was evidence of publication bias and study heterogeneity, and the mean Methodological Index for Non-randomized Studies score was 13 ± 2.6. Conclusion: Flexibility athletes had the highest rate of return to sport after hip arthroscopy for FAIS, while endurance athletes returned the fastest. The difference in rate and time to return to sport and intraoperative procedures performed did not reach statistical significance among the 6 subgroups. These results are limited by the evidence of publication bias and should be interpreted with caution. Laboratory-based studies are necessary to validate the classification of sports based on hip mechanics.

A less-invasive cervical laminoplasty for spondylotic myelopathy that preserves the semispinalis cervicis muscles and nuchal ligament

2013 ◽  
Vol 18 (6) ◽  
pp. 545-552 ◽  
Author(s):  
Masayuki Umeda ◽  
Kunihiko Sasai ◽  
Taketoshi Kushida ◽  
Ei Wakabayashi ◽  
Tokun Maruyama ◽  
...  
Keyword(s):  
Neck Pain ◽  
Japanese Orthopaedic Association ◽  
Neurological Status ◽  
Bony Union ◽  
Cervical Laminoplasty ◽  
Cross Sectional ◽  
Paravertebral Muscles ◽  
The Mean ◽  
The Difference ◽  
Axial Neck Pain

Object Modified cervical laminoplasty techniques have been developed to reduce postoperative axial neck pain and preserve function in patients with cervical spondylotic myelopathy (CSM). However, the previous studies demonstrating satisfactory surgical outcomes had a retrospective design. Here, the authors aimed to prospectively evaluate the 2-year outcomes of a modified cervical laminoplasty technique for CSM that preserves the paravertebral muscles. Methods Outcomes were analyzed for 40 patients (22 men and 18 women; mean age, 66.6 years; age range 44–92 years) with CSM who underwent C4–6 laminoplasty with C-3 and C-7 partial laminectomies or C-3 total and C-7 partial laminectomies and received hydroxyapatite spacers. Neurological, pain severity, and spinal radiographic evaluations were performed preoperatively and at 3, 6, 12, 18, and 24 months postoperatively. Plain radiography and MRI of the cervical spine were performed to evaluate the range of motion (ROM), sagittal alignment, and cross-sectional areas of the deep extensor muscles. The extent of bone–spacer bonding and bony union at the gutter was assessed by CT. Results The mean preoperative Japanese Orthopaedic Association CSM score was 10.2, but it increased to 14.4 by 24 months after surgery. Eleven patients had axial neck pain preoperatively, but only 3 reported mild pain at 24 months, and in all 3 cases the pain was mild. The mean angle of lordosis was 11.7° preoperatively and 12.0° 2 years postoperatively. Although the ROM at the C2–7 levels was significantly reduced 3 months postoperatively, an increasing trend was observed up to 12 months, and 86% of the preoperative ROM was achieved by 2 years postoperatively. The mean paravertebral muscle cross-sectional areas were 833 ± 215 mm2 preoperatively and 763 ± 197 mm2 24 months postoperatively, but the difference was not statistically significant. The rates of bone–spacer bonding and bony union at the gutter were low during the early stages but increased to 90% and 93%, respectively, by 2 years after surgery. Conclusions The modified laminoplasty technique used in this study ensured very good neurological status and ROM after 2 years and was associated with low incidences of axial neck pain and serious complications. This simple and easy operative method could benefit future laminoplasty protocols.

Comparative clinical evaluation of slot versus dovetail Class III composite restorations in primary anterior teeth

2005 ◽  
Vol 28 (2) ◽  
pp. 125-129 ◽  
Author(s):  
Chutima Trairatvorakul ◽  
Supatcharin Piwat
Keyword(s):  
Clinical Characteristics ◽  
Statistical Significance ◽  
Kappa Statistic ◽  
Marginal Adaptation ◽  
Matched Pairs ◽  
Class Iii ◽  
Anterior Teeth ◽  
The Mean ◽  
The Difference ◽  
Clinical Characteristic

This study compares the clinical characteristic evaluations of slot against dovetail class III composite restorations.Focusing on the primary anterior teeth of children aged 2 years 6 months to 5 years 3 months with the mean age of 4 years, thirty-six matched pairs of class III of slot and dovetail preparations were made by one investigator. These preparations were evaluated for marginal adaptation, anatomic form, secondary caries and marginal discoloration after 6, 12, and 24 months by another investigator with the intra-examiner reliability of 0.95 – 1 (Kappa Statistic). The results revealed no statistical significance in the difference of clinical characteristics between the two designs (p > 0.05).

Abstract 2451: Arterial Spin Labelling Provides Usual Clinical Information In Acute Stroke

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Andrew Bivard ◽  
Christopher Levi ◽  
Mark Parsons
Keyword(s):  
Clinical Outcome ◽  
Acute Stroke ◽  
Clinical Information ◽  
Neurological Status ◽  
Mean Value ◽  
Arterial Spin Labelling ◽  
Dynamic Susceptibility ◽  
The Mean ◽  
The Difference ◽  
Spin Labelling

Introduction Arterial Spin Labelling (ASL) is a readily available MR scanning technique and may provide similar information to conventional bolus-tracking dynamic susceptibility MR sequences. However, there is little comparative data in acute stroke. Methods: Patients with an acute ischemic stroke were imaged within 6 hours of ischeamic stroke onset with perfusion CT (CTP) and at 24 hours with MRI, including diffusion weighted MR (DWI),ASL and Perfusion Weighted Magnetic Resonance Imaging (PWI). Patient neurological status was determined using the National institutes of stroke score acutely and at 24 hours, as well as a modified Rankin score at 90 days. The ASL baseline perfusion value was defined as the mean value of the healthy, non ischeamic stroke hemisphere of the patient. Values 20% higher or lower than the mean healthy hemisphere were considered abnormal. A pixel based analysis was also undertaken to compare the perfusion lesion on ASL to the perfusion lesion on the baseline CTP and concurrent PWI maps of CBV, CBF, MTT and Tmax. Results Of the 80 patients in this study there were 32 patients with hyperperfusion in the ischaemic region and 48 with persistent hypoperfusion on follow-up ASL imaging. Hyperperfusion was linked to greater penumbral salvage (defined by the acute CTP and 24 hour DWI) and an improved early clinical outcome (mean improvement in between acute and 24 hour NIHSS = 9) as well as better 3 month outcome (mRS mean = 2, p=0.15). Patients with persistent ASL hypoperfusion showed less improvement in NIHSS (mean improvement 3) and had a poorer 90 day outcome (mean mRS 4). Interestingly, The ASL hypoperfusion lesion was closest to the Tmax PWI map (AUC=0.85) rather than CBF(AUC=0.66) or MTT(AUC=0.73). Discussion. At 24 hours, hyper- or hypo-perfusion on ASL was strongly correlated to clinical outcome. ASL may have clinical utility in the prediction of stroke prognosis based on the difference in clinical outcome (mRS) between the patient groups with hyper- or hypo- perfusion.

scholarly journals Primary Shoulder Arthroplasty Versus Conservative Treatment for Comminuted Proximal Humeral Fractures: A Systematic Literature Review

2010 ◽  
Vol 4 (1) ◽  
pp. 87-92 ◽  
Author(s):  
Dennis den Hartog ◽  
Jeroen de Haan ◽  
Niels W. Schep ◽  
Wim E. Tuinebreijer
Keyword(s):  
Conservative Treatment ◽  
Outcome Measure ◽  
Constant Score ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Conservative Group ◽  
Electronic Search ◽  
The Mean ◽  
The Difference

The objective was to identify whether arthroplasty or conservative treatment is the best available treatment for three- and four-part proximal humeral fractures by analyzing the outcome measure of the Constant score. We conducted an electronic search. The systematic review included 33 studies encompassing 1096 patients with three- or four-part proximal humeral fractures that used the Constant score as outcome measure. The mean Constant score in the conservative group was 66.5 and in the arthroplasty group was 55.5. The difference could be attributed to selection bias, unreliable classification of the fractures and inter-observer differences in the assessment of the Constant score.

scholarly journals Effects of Heavy-Element Abundance on Classification of G-Type Giants

1976 ◽  
Vol 72 ◽  
pp. 147-147
Author(s):  
P. C. Keenan
Keyword(s):  
Heavy Metal ◽  
Metal Ions ◽  
Heavy Metal Ions ◽  
Heavy Element ◽  
Mean Value ◽  
Element Abundance ◽  
Class Iii ◽  
The Mean ◽  
Absolute Magnitudes

Five stars, including ζ Cyg, which had been classified as G6 II to G8 II bright giants, were found by O. C. Wilson to have K-line luminosities close to those of class III giants. These stars show enhancement of the lines of Ba II and other heavy-metal ions also. To eliminate the serious effect of this abundance anomaly on the spectroscopic luminosities new luminosity criteria involving only intercomparisons of lines of elements of the fourth period (Ti, Fe, etc.) were applied on 9 Å mm−1 Coudé spectrograms taken by O. C. Wilson. This Coudé classification gave luminosity classes near IIIa for these stars, implying absolute magnitudes considerably below those of bright giants but somewhat above Wilson's MK values.Another advantage of Coudé classification is the possibility of estimating luminosities for individual barium stars. From Wilson's plate of HD 205011 a luminosity class of III-IIIa is derived. This is consistent with the mean value of Mv = −0.4 derived from statistical parallaxes by MacConnell, Frye and Upgren (Astron. J. 77, (1972), 384) for the barium stars.The detailed account of this investigation will be published elsewhere.

scholarly journals A study on the relationship between morphological lesions of lupus nephritis with demographic and biochemical findings

2021 ◽  
Vol 7 (1) ◽  
pp. e10-e10
Author(s):  
Nasrin Tavassoli ◽  
Hamid Nasri ◽  
Rohollah Valizadeh
Keyword(s):  
Lupus Nephritis ◽  
Serum Creatinine ◽  
Lupus Erythematosus ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Glomerular Sclerosis ◽  
Class Iii ◽  
Cross Sectional ◽  
The Mean

Introduction: Lupus nephritis is one of the important aspects of systemic lupus erythematosus (SLE). Objectives: This study aimed to investigate possible relationship between pathological lesions of lupus nephritis classes and demographic and biochemical findings among patients. Patients and Methods: This is a cross-sectional study that was conducted on a group of renal biopsy proven lupus nephritis patients using lupus nephritis classification of ISN/RPS 2003. We collected demographic data of all patients including age, gender serum creatinine and 24h proteinuria. Results: Data of 101 patients, of whom 78 (77.23%) were females and mean age of 33.54±13.15 years. The mean serum creatinine and proteinuria were 1.54±0.88 mg/dL 2502.5±1495.05 mg/d. Based on our data, IV-G (class IV, diffuse lupus nephritis-global) lupus nephritis class was the most common (39.6%) followed by class III (23.8%). The mean crescent and sclerotic glomeruli were 1.66±3.32 and 2.27±5.32, respectively. In this study, 24 hours proteinuria, serum creatinine, activity percent, chronicity percent, crescent and glomerular sclerosis between genders showed no significant differences (P>0.05). The correlation between plasma creatinine and activity was directly positive and significant (r=0.381, P=0.001). In addition, a significant correlation between C1q deposits and glomerular sclerosis (P=0.031) was detected. Accordingly, a significant correlation between IgG deposits and lupus nephritis classification (P=0.025) was seen. Conclusion: Lupus nephritis of IV-G and III classes of lupus nephritis were most common among patients and higher IgG deposits were observed in patients with IV-G classification. We found a significant correlation between glomerular sclerosis and C1q deposits that could be an indicator of lupus nephritis activity and severity. However, we recommend further studies in this regard.

Classification of fusimotor fibers in the primate

1976 ◽  
Vol 39 (1) ◽  
pp. 9-19 ◽  
Author(s):  
P. D. Cheney ◽  
J. B. Preston
Keyword(s):  
Conduction Velocity ◽  
Muscle Length ◽  
Primary Afferent ◽  
Qualitative Effect ◽  
Afferent Discharge ◽  
The Mean ◽  
The Difference ◽  
Afferent Response ◽  
Fiber Stimulation

The classification and distinguishing characteristics of fusimotor fibres of the baboon soleus muscle have been studied by determining the effects of single fusimotor fiber stimulation on the response of isolated spindle afferents to muscle stretch. As in the cat, fusimotor fibres in the baboon were divisible into static and dynamic types on the basis of the effect of their stimulation at 200/s on the dynamic index of the primary afferent. Single fusimotor fibres had the same qualitative effect-static or dynamic-on all the primary afferents they were found to influence. All static fusimotor fibres produced at least 1 to 1 driving of primary afferent discharge at 50/s if the muscle length was adjusted to optimize conditions for driving. In contrast, 31 of 32 dynamic fusimotor fibres did not produce driving of primary afferent discharge even though all were studied at many different muscle lengths and frequencies of stimulation. Therefore, fusimotor fibres in the baboon could be classified as static or dynamic on the basis of their ability to produce driving of the primary afferent. The ratio of isolated static to dynamic fusimotor fibers was 1.5 to 1. The mean conduction velocity of static fusimotor fibers was 24.1 m/s and that of dynamics was 20.2 m/s. Although the difference between these two means was statistically significant (P less than 0.001), the conduction velocity histograms of static and dynamic fusimotors overlapped, precluding classification by this means. Secondary afferents with one possible exception were concluded to be exclusively activated by static fusimotor fibers. Poststimulus effects of fusimotor stimulation on primary afferent response to stretch were studied. With intervals between the end of stimulation and the beginning of stretch of 0.1 s, dynamic fusimotor stimulation produced facilitation of the primary afferent response to stretch, whereas static fusimotor fibers produced depression.

scholarly journals Energy Expenditure of Standing Compared to Sitting While Conducting Office Tasks

2017 ◽  
Vol 59 (7) ◽  
pp. 1078-1087 ◽  
Author(s):  
Jill Burns ◽  
Cuisle Forde ◽  
Sara Dockrell
Keyword(s):  
Energy Expenditure ◽  
Repeated Measures ◽  
Office Work ◽  
Limited Evidence ◽  
Intensity Physical Activity ◽  
Potential Benefits ◽  
The Mean ◽  
Workplace Needs ◽  
The Difference

Objectives This study aimed to investigate the energy expenditure of common office-based tasks. The objectives were to: (a) test the classification of tasks as sedentary or light-intensity physical activity and (b) compare the energy expenditure of tasks under two postural conditions (sitting and standing). Background The sedentary nature of office work has been highlighted as a health risk, and strategies to reduce sedentary behavior at work have been developed. However, there is limited evidence to guide the utilization of sit-stand workstations in the workplace for metabolic health benefits. Method A repeated measures laboratory-based study compared the energy expenditure of common office tasks in sitting and standing using indirect calorimetry ( n = 22). Four standardized tasks (sitting/standing quietly, reading, typing, sorting paper) under two postural conditions (sitting, standing) were performed in a randomized order. Results The mean energy expenditure for all tasks in sitting and standing was <1.5 METs. There were no significant differences in the energy expenditure of doing the same task in sitting compared to standing. In a repeated measures ANOVA, task ( p < .001) had a greater influence on METs expended than posture ( p = .030). Conclusion The study confirmed that the difference in energy expenditure of tasks carried out in sitting compared to standing is negligible. Application The ubiquitous use and utility of sit-stand workstations in the workplace needs to be reviewed. Notwithstanding the potential benefits of movement that may occur naturally, this study confirmed that standing as opposed to sitting does not produce a clinically important increase in energy expenditure.

Sign in / Sign up

Export Citation Format

Share Document