Motor function in Parkinson's disease and supranuclear palsy: simultaneous factor analysis of a clinical scale in several populations

BACKGROUND: In order to better understand the similarities and differences in the motor behaviour of different groups of patients, their scores on the Motor Examination section of the Unified Parkinson's Disease Rating Scale (UPDRS) were analysed simultaneously. The three groups consisted, respectively, of patients with Parkinson's disease (PD) on medication, patients with Parkinson's disease withdrawn from anti-parkinsonian medication for at least 12 hours, and patients diagnosed with a specific Parkinsonism syndrome: Progressive Supranuclear Palsy (PSP). METHODS: A total of 669 consecutively sampled patients from three separate hospital-based clinics participated (294 PD on medication; 200 PD off medication: 175 PSP). The Motor Examination section of the UPDRS was administered by neurologists at the three participating clinics. The patient scores on each item were recorded. To assess similarities and differences among the components of the UPDRS in these samples, we performed simultaneous or multigroup factor analysis on the covariance matrices of the three groups. In addition, it was investigated whether a single model for the Motor Examination section of the UPDRS could be developed which would be valid for all three groups at the same time. RESULTS: A single six-dimensional factor solution was found that fitted all groups, although this was not straightforward due to differences between the tremor-at-rest variables. The factors were identified as Tremor-at-rest, Postural Tremor, Axial Dysfunctioning, Rigidity, Left Bradykinesia and Right Bradykinesia. The analysis also pointed to a somewhat lower lateralization in bradykinesia for PSP patients. The groups differed in intensity of motor impairment, especially with respect to Tremor-at-Rest, but the overall relationships between the variables were shared by the three groups. In addition, apart from the common factor structure evidence of differences in body part-specific and motor-specific variances was found. CONCLUSION: From a clinical point of view, the analyses showed that using the Motor Examination section of the UPDRS is also appropriate for patients with PSP, because the correlational structure of the items is directly comparable to that of Parkinson's patients. Methodologically, the analysis of all groups together showed that it is possible to evaluate similarities and differences between factor structures in great detail

Boredom Makes Me Sick: Adolescents' Boredom Trajectories and Their Health-Related Quality of Life.

Existing research shows consistent links between boredom and depression, somatic complaints, substance abuse, or obesity and eating disorders. However, comparatively little is known about potential psychological and physical health-related correlates of academic boredom. Evidence for such a relationship can be derived from the literature, as boredom has adverse consequences in both work and achievement-related settings. The present study investigates latent correlations of 1.484 adolescents' (Mage = 13.23) mathematics boredom scores at three time points during a semester in 2018/19 and their Rasch scaled health-related quality of life (HRQoL). Moreover, we applied latent growth curve modeling to estimate boredom trajectories across the semester and determined the relationship between the latent growth parameters of student boredom and HRQoL in bivariate correlation analyses. Our results show that boredom is significantly negatively linked with all HRQoL dimensions (physical well-being, psychological well-being, autonomy and parent relation, social support and peers, school environment [SCH], and general HRQoL [GH]). Furthermore, stronger increases in boredom across the semester were negatively associated with SCH scores and GH. In conclusion, given that boredom is negatively linked with HRQoL and that stronger boredom growth is linked with more severe health-related problems, signs of academic boredom could be an early warning signal for adolescents' potentially severe problems

Kinetic-scale Spectral Features of Cross Helicity and Residual Energy in the Inner Heliosphere

In this work, we present the first results from the flux angle (FA) operation mode of the Faraday Cup instrument on board the Parker Solar Probe (PSP). The FA mode allows rapid measurements of phase space density fluctuations close to the peak of the proton velocity distribution function with a cadence of 293 Hz. This approach provides an invaluable tool for understanding kinetic-scale turbulence in the solar wind and solar corona. We describe a technique to convert the phase space density fluctuations into vector velocity components and compute several turbulence parameters, such as spectral index, residual energy, and cross helicity during two intervals when the FA mode was used in PSP's first encounter at 0.174 au distance from the Sun

The Enhancement of Proton Stochastic Heating in the Near-Sun Solar Wind

International audienceStochastic heating (SH) is a nonlinear heating mechanism driven by the violation of magnetic moment invariance due to large-amplitude turbulent fluctuations producing diffusion of ions toward higher kinetic energies in the direction perpendicular to the magnetic field. It is frequently invoked as a mechanism responsible for the heating of ions in the solar wind. Here, we quantify for the first time the proton SH rate Q(perpendicular to) at radial distances from the Sun as close as 0.16 au, using measurements from the first two Parker Solar Probe encounters. Our results for both the amplitude and radial trend of the heating rate, Q(perpendicular to) proportional to r(-2.5), agree with previous results based on the Helios data set at heliocentric distances from 0.3 to 0.9 au. Also in agreement with previous results, Q(perpendicular to) is significantly larger in the fast solar wind than in the slow solar wind. We identify the tendency in fast solar wind for cuts of the core proton velocity distribution transverse to the magnetic field to exhibit a flattop shape. The observed distribution agrees with previous theoretical predictions for fast solar wind where SH is the dominant heating mechanism

Sharp Alfvenic impulses in the near-Sun solar wind

Measurements of the near-Sun solar wind by Parker Solar Probe have revealed the presence of largenumbers of discrete Alfv ́enic impulses with an anti-Sunward sense of propagation. These are similarto those previously observed near 1 AU, in high speed streams over the Sun’s poles and at 60 solarradii. At 35 solar radii, however, they are typically shorter and sharper than seen elsewhere. Inaddition, these spikes occur in “patches” and there are also clear periods within the same stream whenthey do not occur; the timescale of these patches might be related to the rate at which the spacecraftmagnetic footpoint tracks across the coronal hole from which the plasma originated. While the velocityfluctuations associated with these spikes are typically under 100 km/s, due to the rather low Alfv ́enspeeds in the streams observed by the spacecraft to date, these are still associated with large angulardeflections of the magnetic field - and these deflections are not isotropic. These deflections do notappear to be related to the recently reported large scale, pro-rotation solar wind flow. Estimates ofthe size and shape of the spikes reveal high aspect ratio flow-aligned structures with a transverse scaleof≈104km. These events might be signatures of near-Sun impulsive reconnection events

Ion-scale Electromagnetic Waves in the Inner Heliosphere

International audienceUnderstanding the physical processes in the solar wind and corona that actively contribute to heating, acceleration, and dissipation is a primary objective of NASA's Parker Solar Probe (PSP) mission. Observations of circularly polarized electromagnetic waves at ion scales suggest that cyclotron resonance and wave-particle interactions are dynamically relevant in the inner heliosphere. A wavelet-based statistical study of circularly polarized events in the first perihelion encounter of PSP demonstrates that transverse electromagnetic waves at ion resonant scales are observed in 30-50% of radial field intervals. Average wave amplitudes of approximately 4 nT are measured, while the mean duration of wave events is on the order of 20 s; however, long-duration wave events can exist without interruption on hour-long timescales. Determination of wave vectors suggests propagation parallel/antiparallel to the mean magnetic field. Though ion-scale waves are preferentially observed during intervals with a radial mean magnetic field, we show that measurement constraints, associated with single spacecraft sampling of quasi-parallel waves superposed with anisotropic turbulence, render the measured coherent ion-wave spectrum unobservable when the mean magnetic field is oblique to the solar wind flow; these results imply that the occurrence of coherent ion-scale waves is not limited to a radial field configuration. The lack of radial scaling of characteristic wave amplitudes and duration suggests that the waves are generated in situ through plasma instabilities. Additionally, observations of proton distribution functions indicate that temperature anisotropy may drive the observed ion-scale

Questionnaire of chronic illness care in primary care-psychometric properties and test-retest reliability

<p>Abstract</p> <p>Background</p> <p>The Chronic Care Model (CCM) is an evidence-based approach to improving the structure of care for chronically ill patients with multimorbidity. The Assessment of Chronic Illness Care (ACIC), an instrument commonly used in international research, includes all aspects of the CCM, but cannot be easily extended to the German context. A new instrument called the "Questionnaire of Chronic Illness Care in Primary Care" (QCPC) was developed for use in Germany for this reason. Here, we present the results of the psychometric properties and test-retest reliability of QCPC.</p> <p>Methods</p> <p>A total of 109 family doctors from different German states participated in the validation study. Participating physicians completed the QCPC, which includes items concerning the CCM and practice structure, at baseline (T0) and 3 weeks later (T1). Internal consistency reliability and test-retest reliability were evaluated using Cronbach's alpha and Pearson's r, respectively.</p> <p>Results</p> <p>The QCPC contains five elements of the CCM (decision support, delivery system design, self-management support, clinical information systems, and community linkages). All subscales demonstrated moderate internal consistency and moderate test-retest reliability over a three-week interval.</p> <p>Conclusions</p> <p>The QCPC is an appropriate instrument to assess the structure of chronic illness care. Unlike the ACIC, the QCPC can be used by health care providers without CCM training. The QCPC can detect the actual state of care as well as areas for improvement of care according to the CCM.</p

The Retrograde IFT Machinery of C. elegans Cilia: Two IFT Dynein Complexes?

We analyzed the relatively poorly understood IFT-dynein (class DYNC2)-driven retrograde IFT pathway in C. elegans cilia, which yielded results that are surprising in the context of current models of IFT. Assays of C. elegans dynein gene expression and intraflagellar transport (IFT) suggest that conventional IFT-dynein contains essential heavy (CHE-3), light-intermediate (XBX-1), plus three light polypeptide chains that participate in IFT, but no “essential” intermediate chain. IFT assays of XBX-1::YFP suggest that IFT-dynein is transported as cargo to the distal tip of the cilium by kinesin-2 motors, but independent of the IFT-particle/BBSome complexes. Finally, we were surprised to find that the subset of cilia present on the OLQ (outer labial quadrant) neurons assemble independently of conventional “CHE-3” IFT-dynein, implying that there is a second IFT-dynein acting in these cilia. We have found a novel gene encoding a dynein heavy chain, DHC-3, and two light chains, in OLQ neurons, which could constitute an IFT-dynein complex in OLQ neuronal cilia. Our results underscore several surprising features of retrograde IFT that require clarification

Effects of Short-Term Continuous Subcutaneous Insulin Infusion on Fasting Plasma Fibroblast Growth Factor-21 Levels in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

To investigate the effects of short-term continuous subcutaneous insulin infusion (CSII) on plasma fibroblast growth factor-21 (FGF-21) levels in patients with newly diagnosed type 2 diabetes mellitus (nT2DM).Sixty-eight patients with nT2DM (nT2DM group), and 52 gender-, age- and body mass index (BMI) -matched normal glucose tolerance (NGT group) controls participated in the study. 30 nT2DM patients with FBG≥14.0 mmol/L were treated with CSII for 2 weeks, and were underwent a euglycemic–hyperinsulinemic clamp pre- and post-treatment. Plasma FGF-21 concentrations were measured with a commercial ELISA kit. The relationship between plasma FGF-21 levels and metabolic parameters was also analyzed.<0.05), accompanied by a significant increase in the whole body glucose uptake (M value) and blood glucose control. The changes in plasma FGF-21 levels (ΔFGF-21) were positively associated with the amelioration of insulin resistance shown by the changes in M value.Plasma FGF-21 level is associated with whole body insulin sensitivity and significantly reduced following short-term CSII treatment

Mucosal Lipocalin 2 Has Pro-Inflammatory and Iron-Sequestering Effects in Response to Bacterial Enterobactin

Nasal colonization by both gram-positive and gram-negative pathogens induces expression of the innate immune protein lipocalin 2 (Lcn2). Lcn2 binds and sequesters the iron-scavenging siderophore enterobactin (Ent), preventing bacterial iron acquisition. In addition, Lcn2 bound to Ent induces release of IL-8 from cultured respiratory cells. As a countermeasure, pathogens of the Enterobacteriaceae family such as Klebsiella pneumoniae produce additional siderophores such as yersiniabactin (Ybt) and contain the iroA locus encoding an Ent glycosylase that prevents Lcn2 binding. Whereas the ability of Lcn2 to sequester iron is well described, the ability of Lcn2 to induce inflammation during infection is unknown. To study each potential effect of Lcn2 on colonization, we exploited K. pneumoniae mutants that are predicted to be susceptible to Lcn2-mediated iron sequestration (iroA ybtS mutant) or inflammation (iroA mutant), or to not interact with Lcn2 (entB mutant). During murine nasal colonization, the iroA ybtS double mutant was inhibited in an Lcn2-dependent manner, indicating that the iroA locus protects against Lcn2-mediated growth inhibition. Since the iroA single mutant was not inhibited, production of Ybt circumvents the iron sequestration effect of Lcn2 binding to Ent. However, colonization with the iroA mutant induced an increased influx of neutrophils compared to the entB mutant. This enhanced neutrophil response to Ent-producing K. pneumoniae was Lcn2-dependent. These findings suggest that Lcn2 has both pro-inflammatory and iron-sequestering effects along the respiratory mucosa in response to bacterial Ent. Therefore, Lcn2 may represent a novel mechanism of sensing microbial metabolism to modulate the host response appropriately