Evaluation of upper extremity ataxia through image processing in individuals with multiple sclerosis

ABSTRACT Background: Impaired dexterity is a frequently reported disability among people with ataxic multiple sclerosis (MS). Objective: To quantify and standardize the evaluation of upper extremity coordination disorder among patients with multiple sclerosis (MS), using the Tablet Ataxia Assessment Program (TAAP). Methods: The X and Y axis movements of 50 MS patients and 30 healthy individuals who were evaluated using the International Cooperative Ataxia Rating Scale (ICARS) were also assessed using TAAP. The functional times of the participants’ right and left hands were recorded using the nine-hole peg test (NHPT). The upper extremity coordination of individuals with MS was evaluated using the upper extremity kinetic functions section of ICARS. Results: The deviations for the X and Y axis movements of the MS group were greater than those of the control group (p<0.05). Significant correlations were shown between TAAP scores and NHPT and ICARS scores. The strongest correlation was found between NHPT and ICARS in the dominant hand (rnhpt=0.356, pnhpt=0.001; ricars=0.439, picars=0.000). In correlating the Y axis with ICARS, the deviations in the Y axis were found to be greater in the non-dominant hand than those in the X axis (ryright=0.402, pyright=0.004; ryleft=0.691, pyleft=0.000). Conclusion: Measurement using TAAP is more sensitive than other classical and current methods for evaluating ataxia. We think that TAAP is an objective tool that will allow neurorehabilitation professionals and clinicians to evaluate upper extremity coordination.

Frailty Score as a Predictor of Outcomes in Geriatric Patients with Isolated Hip Fractures

Background Isolated hip fractures (IHFs) are a cause of morbidity and mortality in the geriatric population aged >65 years. Frailty has been identified as a determinant for patient outcomes in other surgical specialties. The purpose of this study is to determine if frailty severity is a predictor of outcomes in IHF in the geriatric population. Methods This is a retrospective study in a state and ACS Level 2 trauma center. Patients with IHF were reviewed between January 2018 and January 2020. Primary outcome was in-patient mortality. Secondary outcomes include perioperative outcome measures such as UTI, HCAP, DVT, readmission, length of stay, ICU length of stay, nutritional status, and discharge destination. Patients were stratified into mild (1-2), moderate (3-5), and severe (5-7) frailty using the Rockwood Frailty Score (RFS). Clinical characteristics and outcomes were analyzed. Results We identified 470 patients with IHF who were stratified by mild (N=316), moderate (N-123), and severe (N=31) frailty. Frailty worsened with increasing age (P < .0001). Those who were less frail were more likely discharged home (P < .04). Severely frail patients were more likely discharged to hospice (P < .01). Severely frail patients also were more likely to develop DVT (P < .04) and have poorer nutritional status (P < .02). There were no differences among groups for in-patient mortality. Conclusion Severely frail patients are more likely to be malnourished at baseline and be discharged to hospice care. The RFS is a reliable objective tool to identify high-risk patients and guide goals of care discussion for operative intervention in isolated traumatic hip fractures.

On WEIRD Anthropologists and Their White Skeletons

Most forensic anthropologists and the populations they study are WEIRD—that is, Western, educated, industrialized, rich, and democratic. In their interventions into the WEIRD, Clancy and Davis (2019) contend that WEIRD is a euphemism for white and that it is the white, Western European–derived scientists and subjects that skew the predominating narrative of the human condition. While they demonstrate how biological anthropology can decenter the WEIRD, it is fruitful to extend their framework specifically to forensic anthropology. We argue that the scientific enterprise of forensic anthropology is unique in that: (1) it is touted as an objective tool that must operate within medicolegal systems, (2) it involves board certification and accreditation standards, and (3) it holds ancestry and race as core to its practice. In a bibliometric survey of journal articles over the past five years (n = 793), we find that up to 79% of authors originate from WEIRD contexts. In articles specifically studying ancestry, European-derived populations are included 88% of the time as a category for comparison to other groups, while only 12% do not include Europeans. Furthermore, 49% of articles unrelated to ancestry use white subjects solely or in part, reinforcing a historic tendency to measure all human variation against one particular norm. We also find that WEIRD articles receive significantly more recognition than non-WEIRD counterparts. In this reflexive and positional exercise, we hope to make visible how whiteness as WEIRDness informs the history, values, and practices of forensic anthropology on a global scale.

A Novel Light Weight Approach For Identification of Psoriasis Affected Skin Lesion Using Deep Learning.

Psoriasis is a skin disorder which affects the people physically, mentally and emotionally. It is characterized as rough elevated scaly skin which is evident from surrounding skin area. There are various types of psoriasis which include plaque psoriasis, nail psoriasis, guttate psoriasis, inverse psoriasis, pustular psoriasis, erythrodermic psoriasis and psoriatic arthritis. The common trend observed is that the people tend to face difficulties in differentiating and tracking the disorder which will worsen the situation of the affected skin. It is essential to keep track of the affected skin for the prognosis of the disorder. In this work, an attempt is made to identify the psoriasis affected area automatically using MobileNet machine learning model which will become an objective tool in accurate identification of the disorder which in turn helps in effective treatment of the disorder.

The questionnaire as a tool for collecting information in support of medical researchers

In medical and epidemiological research, multi-item questionnaires are often used to assess changes in the health of a particular group of subjects over a certain period. They can target a selected population sample based on specific exposure characteristics or target the whole population. Also, they can constitute an objective tool to help health professionals improve the quality of life and guide patients to the most appropriate care suitable [1,2]. Trying to complete an entirely new questionnaire or translating an existing questionnaire from another language can be difficult. The biggest challenge is making a questionnaire that is effective for use in research and clinical conditions. This article tries to guide for adapting validated and translated questionnaires to apply them to various population categories. We want to support readers less familiar with the process of developing and adapting validated questionnaires. Although using an existing questionnaire will save time and resources, a questionnaire that includes all items of interest to the researcher may not be available, or the current questionnaire may not be translated into the language required for respondents. If no already validated questionnaires are available or suitable, it is necessary to design a new questionnaire. For this, there are several steps to follow that one must take into account.

Semiautomated 3D mapping of aneurysmal wall enhancement with 7T-MRI

Aneurysm wall enhancement (AWE) after the administration of contrast gadolinium is a potential biomarker of unstable intracranial aneurysms. While most studies determine AWE subjectively, this study comprehensively quantified AWE in 3D imaging using a semi-automated method. Thirty patients with 33 unruptured intracranial aneurysms prospectively underwent high-resolution imaging with 7T-MRI. The signal intensity (SI) of the aneurysm wall was mapped and normalized to the pituitary stalk (PS) and corpus callosum (CC). The CC proved to be a more reliable normalizing structure in detecting contrast enhancement (p < 0.0001). 3D-heatmaps and histogram analysis of AWE were used to generate the following metrics: specific aneurysm wall enhancement (SAWE), general aneurysm wall enhancement (GAWE) and focal aneurysm wall enhancement (FAWE). GAWE was more accurate in detecting known morphological determinants of aneurysm instability such as size ≥ 7 mm (p = 0.049), size ratio (p = 0.01) and aspect ratio (p = 0.002). SAWE and FAWE were aneurysm specific metrics used to characterize enhancement patterns within the aneurysm wall and the distribution of enhancement along the aneurysm. Blebs were easily identified on 3D-heatmaps and were more enhancing than aneurysm sacs (p = 0.0017). 3D-AWE mapping may be a powerful objective tool in characterizing different biological processes of the aneurysm wall.

Validation of a new objective method to assess lipid layer thickness without the need of an interferometer

Purpose This study aimed to develop and validate new metrics to objectively assess the lipid layer thickness (LLT) through the analysis of grey intensity values obtained from the Placido disk pattern reflected onto the tear film. Methods Ocular surface parameters were measured using Oculus Keratograph 5 M in 94 healthy volunteers (43.8 ± 26.8 years). Subjects’ LLT was subjectively classified into 4 groups using an interferometry-based grading scale. New metrics based on the intensity of the Placido disk images were calculated and compared between groups. The repeatability of the new metrics and their diagnostic ability was analysed through receiver operating characteristics (ROC) curves. The level of agreement between the new objective tool and the existing subjective classification scale was analysed by means accuracy, weighted Kappa index and F-measure. Results Mean pixel intensity, median pixel intensity and relative energy at 5.33 s after blinking achieved the highest performance, with a correlation with LLT between r = 0.655 and 0.674 (p < 0.001), sensitivity between 0.92 and 0.94, specificity between 0.79 and 0.81, area under the ROC curve between 0.89 and 0.91, accuracy between 0.76 and 0.77, weighted Kappa index of 0.77 and F-measure between 0.86 and 0.87. Conclusion The analysis of grey intensity values in videokeratography can be used as an objective tool to assess LLT. These new metrics could be included in a battery of clinical tests as an easy, repeatable, objective and accessible method to improve the detection and monitoring of dry eye disease and meibomian gland dysfunction.

Phenol Biological Metabolites as Food Intake Biomarkers, a Pending Signature for a Complete Understanding of the Beneficial Effects of the Mediterranean Diet

The Mediterranean diet (MD) has become a dietary pattern of reference due to its preventive effects against chronic diseases, especially relevant in cardiovascular diseases (CVD). Establishing an objective tool to determine the degree of adherence to the MD is a pending task and deserves consideration. The central axis that distinguishes the MD from other dietary patterns is the choice and modality of food consumption. Identification of intake biomarkers of commonly consumed foods is a key strategy for estimating the degree of adherence to the MD and understanding the protective mechanisms that lead to a positive impact on health. Throughout this review we propose potential candidates to be validated as MD adherence biomarkers, with particular focus on the metabolites derived from the phenolic compounds that are associated with the consumption of typical Mediterranean plant foods. Certain phenolic metabolites are good indicators of the intake of specific foods, but others denote the intake of a wide-range of foods. For this, it is important to emphasise the need to increase the number of dietary interventions with specific foods in order to validate the biomarkers of MD adherence. Moreover, the identification and quantification of food phenolic intake biomarkers encouraging scientific research focuses on the study of the biological mechanisms in which polyphenols are involved.

Electroencephalogram Application for the Analysis of Stress Relief in the Seasonal Landscape

This study proposes an integrated approach to assess the psychological and physiological responses of people in natural seasonal landscapes. The questionnaire of restoration outcomes scale (ROS), willingness to visit (WTV), cultural ecosystem services (CES) cognitive classification, and the neuroscientific technique based on electroencephalogram (EEG) measurements were applied. The effects of different landscapes on human perception were studied by comparing the EEG data of different landscape types and different seasons. The coupling relationship between EEG data and stress recovery was also examined. The results showed the following: First, there was a significant difference between the winter landscape and the summer natural landscape. Second, only the winter landscape showed significant gender differences. Third, the values of ROS and WTV in the summer landscape were greater than those in the winter landscape. Fourth, the number of CES in the summer landscape was significantly higher than that in the winter landscape, and the number of CES in water was higher than that in the forest and grassland. Thus, brain wave data and quantified values from questionnaires including ROS, WTV, and CES showed significant seasonality. Therefore, an EEG can be used as a new, more objective tool and method for landscape evaluation and planning in the future.