Adding a subjective dimension to an ICF-based disability measure for people with multiple sclerosis: development and use of a measure for perception of disabilities

OBJECTIVE: The subjective dimension of disability, the perception of disability, is a dimension missing from the International Classification of Functioning, Disability and Health (ICF), and from health-related quality of life (HRQOL) instruments. However, it is a highly relevant dimension for clinical practice as perceived disability may identify care needs. We therefore developed a measure for this subjective dimension of disability in multiple sclerosis (MS) and examined the contribution of this dimension to QOL. METHOD: A measure named the Multiple Sclerosis Impact Profile-Disability Perception (MSIP-DP) was developed to reflect a person's perception of disabilities reported using the original MSIP-disability (MSIP-D) items. MS patients (n=530) completed both MSIP sections, the medical outcome study short form questionnaire (SF-36), the World Health Organisation Quality Of Life-BREF (WHOQOL-BREF) and questions concerning disease severity. The contribution of disability perception (DP) to QOL in MS was estimated using hierarchical multiple regression analyses after controlling for MS severity. RESULTS: Confirmative factor analysis confirmed the hypothesised disability perception domains that correspond with the related disability domains in the MSIP. DP scales yielded sufficient reliability. DP explained a unique and substantial part of the variance in QOL, particularly the perception of impairments in mental functions. DISCUSSION: Results indicated that the subjective dimension of functioning and health operationalised in the MSIP-DP is a relevant concept in explaining QOL in MS. In clinical practice psychological interventions addressing a patient's perception of disability, particularly of impairments in mental functioning, may contribute to QOL

Chronic progressive lymphedema in the Belgian draft horse in Belgium: clinical phenotyping, prevalence and risk factor analysis

Chronic progressive lymphedema (CPL) is a well-known problem in the Belgian draft horse. However, tools for clinical diagnosis have not been standardized. Therefore, the exact disease prevalence and the possible CPL risk factors have not been investigated in the Belgian breed yet. The aim of the present study was to assess a uniform CPL clinical examination method to increase diagnostic objectivity as well as to determine the occurrence and severity of lesions. Using univariate and stepwise multivariable logistic regression models, the association of factors, such as age-gender interaction, coat color and season, with CPL occurrence was examined. In this study, it was demonstrated that CPL is highly prevalent in the Belgian draft horse: 60.66% of the horses of the total sample were affected, including a large proportion of young horses (= 3 years). In the latter, the lesions were more explicit as CPL is a chronic disorder. In some horses (i.e. 14% of the yearlings), mild clinical symptoms appeared at approximately the age of one, while distinct onset of the disease occurred from the age of three onwards. The factors age-gender interaction, coat color and season, which are significantly associated with CPL occurrence, were identified and quantified. In this study, a standardized diagnostic protocol is proposed that will enhance future data collection and furthermore will offer a foundation for quantitative genetic research. Ultimately, it will help to reduce CPL occurrence in the Belgian draft horse by means of selection

Broadening the scope on health problems among the chronically neurologically ill with the International Classification of Functioning (ICF)

Purpose. The aim of this study was to determine ICF items indicating health problems for patients with a chronic neurological disorder such as multiple sclerosis, Parkinson's disease and neuromuscular disease. Method. A Delphi study using three disease-specific panels composed of patients and proxies, medical and non-medical health professionals (N=98). Panels were asked to select items from the International Classification of Functioning, Disability and Health (ICF) reflecting relevant disease-specific health problems. Items appraised as relevant by the panel members were compared with items in established measures namely: the Minimal Record of Disability (MRD) and the Disability and Impact Profile (DIP). Results. Sixty-eight ICF items were considered to be the most relevant, and belonged to four ICF domains. No significant differences were found between the appraisal of items by patients/proxies and health professionals. Agreement across the disease panels appeared to be (very) strong. Differences between the three disease-specific panels were found for the 'Body Functions and Structures' domain: consensus was reached by extension of the inclusion criteria. The ICF-item selection covers almost all items of the established measures. The largest contrast was shown in the item selection for the 'participation' and 'environmental factors' domains. Conclusions. Selected items indicate a broader scope in studying health problems compared with widely used health status measures in neurology, especially for the ICF domains 'Participation' and 'Environmental Factors'

Direct visualization of magnetic vortex pinning in superconductors

We study the vortex structure in a Pb film deposited on top of a periodic array of ferromagnetic square microrings by combining two high resolution imaging techniques: Bitter decoration and scanning Hall probe microscopy (SHPM). The periodicity and strength of the magnetic pinning potential generated by the square microrings are controlled by the magnetic history of the template. When the square rings are in the magnetized dipolar state, known as the onion state, the strong stray field generated at the domain walls prevents the decoration of vortices. SHPM images show that the stray field generated by the dipoles is much stronger than the vortex field in agreement with the results of simulations. Real space vortex imaging has revealed that, in the onion state, the corners of the square rings act as effective pinning centers for vortices.Comment: To be published in Phys. Rev.

Identification and characterization of a new ensemble of cometary organic molecules.

In-situ study of comet 1P/Halley during its 1986 apparition revealed a surprising abundance of organic coma species. It remained unclear, whether or not these species originated from polymeric matter. Now, high-resolution mass-spectrometric data collected at comet 67P/Churyumov-Gerasimenko by ESA's Rosetta mission unveil the chemical structure of complex cometary organics. Here, we identify an ensemble of individual molecules with masses up to 140 Da while demonstrating inconsistency of the data with relevant amounts of polymeric matter. The ensemble has an average composition of C1H1.56O0.134N0.046S0.017, identical to meteoritic soluble organic matter, and includes a plethora of chain-based, cyclic, and aromatic hydrocarbons at an approximate ratio of 6:3:1. Its compositional and structural properties, except for the H/C ratio, resemble those of other Solar System reservoirs of organics-from organic material in the Saturnian ring rain to meteoritic soluble and insoluble organic matter -, which is compatible with a shared prestellar history

Polymorphisms in the ficolin 1 gene (FCN1) are associated with susceptibility to the development of rheumatoid arthritis

Objectives. We investigated the possible association of rheumatoid arthritis (RA) with single nucleotide polymorphisms (SNP) within the ficolin (FCN) genes. Two SNPs in the FCN1 gene, four SNPs in the FCN2 gene and one SNP in the FCN3 gene were studied. Methods. The SNPs within the FCN genes were detected by an experimental INNO-LiPA methodology (Innogenetics, Belgium) in a population consisting of 338 RA patients and 595 controls. The significant SNPs were further evaluated in two subpopulations and related to carriage of the human leukocyte antigen-shared epitope (HLA-SE), rheumatoid factor (RF) and the presence of anti-citrullinated protein/peptide antibodies (ACPA). Results. Two SNPs in the FCN1 gene were significantly associated with RA: the A allele rs2989727 was significantly increased in RA patients (67%) compared with controls (60%) (P = 0.002). Also, the frequency of the G allele of rs1071583 was increased in RA patients (68%) compared with controls (61%) (P = 0.003). Analysis of agreement between SNPs suggested strong linkage between rs2989727 and rs1071583. Carriage of a FCN1 SNP was independent of carriage of the HLA-SE, RF status and ACPA positivity. Conclusions. We describe two linked SNPs in the FCN1 gene that are associated with the development of RA

Context and driver dependent hybrid electrical vehicle operation

This paper studies the driver and context changes during the operation of a hybrid electric vehicle (HEV) and their influence on fuel consumption. Firstly, a context estimation model to recognize driving styles is developed based on machine learning techniques, for which a realistic scenario with simulation of urban mobility (SUMO) and car modeling platform (IPG Carmaker) integration is designed. Secondly, a novel context-aware control strategy based on model predictive control with extended prediction self-adaptive control (MPC-EPSAC) strategy is proposed. The control objective is to achieve optimal torque-split distribution, while optimizing fuel consumption in the parallel HEV. The simulation results suggest that an improvement in fuel economy can be achieved when the driving style in the control loop is adequately considered. Copyright (C) 2020 The Authors