Balance differences in people with Parkinson disease with and without freezing of gait

Published in final edited form as: Gait Posture. 2015 September ; 42(3): 306–309. doi:10.1016/j.gaitpost.2015.06.007.BACKGROUND: Freezing of gait (FOG) is a relatively common and remarkably disabling impairment associated with Parkinson disease (PD). Laboratory-based measures indicate that individuals with FOG (PD+FOG) have greater balance deficits than those without FOG (PD-FOG). Whether such differences also can be detected using clinical balance tests has not been investigated. We sought to determine if balance and specific aspects of balance, measured using Balance Evaluation Systems Test (BESTest), differs between PD+FOG and PD-FOG. Furthermore, we aimed to determine if time-efficient clinical balance measures (i.e. Mini-BESTest, Berg Balance Scale (BBS)) could detect balance differences between PD+FOG and PD-FOG. METHODS: Balance of 78 individuals with PD, grouped as either PD+FOG (n=32) or PD-FOG (n=46), was measured using the BESTest, Mini-BESTest, and BBS. Between-groups comparisons were conducted for these measures and for the six sections of the BESTest using analysis of covariance. A PD composite score was used as a covariate. RESULTS: Controlling for motor sign severity, PD duration, and age, PD+FOG had worse balance than PD-FOG when measured using the BESTest (p=0.008, F=7.35) and Mini-BESTest (p=0.002, F=10.37), but not the BBS (p=0.27, F=1.26). BESTest section differences were noted between PD+FOG and PD-FOG for reactive postural responses (p<0.001, F=14.42) and stability in gait (p=0.003, F=9.18). CONCLUSIONS: The BESTest and Mini-BESTest, which specifically assessed reactive postural responses and stability in gait, were more likely than the BBS to detect differences in balance between PD+FOG and PD-FOG. Because it is more time efficient to administer, the Mini-BESTest may be the preferred tool for assessing balance deficits associated with FOG.This study was conducted with funding from the Davis Phinney Foundation, Parkinson's Disease Foundation, NIH R01 NS077959, NIH UL1 TR000448, Greater St. Louis American Parkinson Disease Association (APDA), APDA Center for Advanced PD Research at Washington University in St. Louis. The funding sources had no role in the study design, in the collection, analysis and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication. (Davis Phinney Foundation; Parkinson's Disease Foundation; R01 NS077959 - NIH; UL1 TR000448 - NIH; Greater St. Louis American Parkinson Disease Association (APDA); APDA Center for Advanced PD Research at Washington University in St. Louis

Short-range cluster spin glass near optimal superconductivity in BaFe2−x_{2-x}Nix_{x}As2_{2}

High-temperature superconductivity in iron pnictides occurs when electrons are doped into their antiferromagnetic (AF) parent compounds. In addition to inducing superconductivity, electron-doping also changes the static commensurate AF order in the undoped parent compounds into short-range incommensurate AF order near optimal superconductivity. Here we use neutron scattering to demonstrate that the incommensurate AF order in BaFe$_{2-x}$Ni$_{x}$As$_{2}$ is not a spin-density-wave arising from the itinerant electrons in nested Fermi surfaces, but consistent with a cluster spin glass in the matrix of the superconducting phase. Therefore, optimal superconductivity in iron pnictides coexists and competes with a mesoscopically separated cluster spin glass phase, much different from the homogeneous coexisting AF and superconducting phases in the underdoped regime.Comment: 4 figure

Data-driven prediction of vortex-induced vibration response of marine risers subjected to three-dimensional current

Slender marine structures such as deep-water marine risers are subjected to currents and will normally experience Vortex Induced Vibrations (VIV), which can cause fast accumulation of fatigue damage. The ocean current is often three-dimensional (3D), i.e., the direction and magnitude of the current vary throughout the water column. Today, semi-empirical tools are used by the industry to predict VIV induced fatigue on risers. The load model and hydrodynamic parameters in present VIV prediction tools are developed based on two-dimensional (2D) flow conditions, as it is challenging to consider the effect of 3D flow along the risers. Accordingly, the current profiles must be purposely made 2D during the design process, which leads to significant uncertainty in the prediction results. Further, due to the limitations in the laboratory, VIV model tests are mostly carried out under 2D flow conditions and thus little experimental data exist to document VIV response of riser subjected to varying directions of the current. However, a few experiments have been conducted with 3D current. We have used results from one of these experiments to investigate how well 1) traditional and 2) an alternative method based on a data driven prediction can describe VIV in 3D currents. Data driven modelling is particularly suited for complicated problems with many parameters and non-linear relationships. We have applied a data clustering algorithm to the experimental 3D flow data in order to identify measurable parameters that can influence responses. The riser responses are grouped based on their statistical characteristics, which relate to the direction of the flow. Furthermore we fit a random forest regression model to the measured VIV response and compare its performance with the predictions of existing VIV prediction tools (VIVANA-FD).Comment: 12 pages, presented at Norwegian AI Society Symposium 2019, accepted for publication in Springer Conference Proceeding

External validation of a simple clinical tool used to predict falls in people with Parkinson disease

Published in final edited form as: Parkinsonism Relat Disord. 2015 August ; 21(8): 960–963. doi:10.1016/j.parkreldis.2015.05.008.BACKGROUND: Assessment of fall risk in an individual with Parkinson disease (PD) is a critical yet often time consuming component of patient care. Recently a simple clinical prediction tool based only on fall history in the previous year, freezing of gait in the past month, and gait velocity <1.1 m/s was developed and accurately predicted future falls in a sample of individuals with PD. METHODS: We sought to externally validate the utility of the tool by administering it to a different cohort of 171 individuals with PD. Falls were monitored prospectively for 6 months following predictor assessment. RESULTS: The tool accurately discriminated future fallers from non-fallers (area under the curve [AUC] = 0.83; 95% CI 0.76–0.89), comparable to the developmental study. CONCLUSION: The results validated the utility of the tool for allowing clinicians to quickly and accurately identify an individual's risk of an impending fall.Davis Phinney Foundation, Parkinson Disease Foundation, NIH, APDA. (Davis Phinney Foundation; Parkinson Disease Foundation; NIH; APDA

Are the average gait speeds during the 10 meter and 6 minute walk tests redundant in Parkinson disease?

Published in final edited form as: Gait Posture. 2017 February ; 52: 178–182. doi:10.1016/j.gaitpost.2016.11.033.We investigated the relationships between average gait speed collected with the 10Meter Walk Test (Comfortable and Fast) and 6Minute Walk Test (6MWT) in 346 people with Parkinson disease (PD) and how the relationships change with increasing disease severity. Pearson correlation and linear regression analyses determined relationships between 10Meter Walk Test and 6MWT gait speed values for the entire sample and for sub-samples stratified by Hoehn & Yahr (H&Y) stage I (n=53), II (n=141), III (n=135) and IV (n=17). We hypothesized that redundant tests would be highly and significantly correlated (i.e. r>0.70, p<0.05) and would have a linear regression model slope of 1 and intercept of 0. For the entire sample, 6MWT gait speed was significantly (p<0.001) related to the Comfortable 10 Meter Walk Test (r=0.75) and Fast 10Meter Walk Test (r=0.79) gait speed, with 56% and 62% of the variance in 6MWT gait speed explained, respectively. The regression model of 6MWT gait speed predicted by Comfortable 10 Meter Walk gait speed produced slope and intercept values near 1 and 0, respectively, especially for participants in H&Y stages II-IV. In contrast, slope and intercept values were further from 1 and 0, respectively, for the Fast 10Meter Walk Test. Comfortable 10 Meter Walk Test and 6MWT gait speeds appeared to be redundant in people with moderate to severe PD, suggesting the Comfortable 10 Meter Walk Test can be used to estimate 6MWT distance in this population.This study was funded by the Davis Phinney Foundation, the Parkinson's Disease Foundation, and the National Institutes of Health (R01 NS077959, K12 HD055931, UL1 TR000448). The funding sources had no input related to study design, data collection, or decision to submit for publication. (Davis Phinney Foundation; Parkinson's Disease Foundation; R01 NS077959 - National Institutes of Health; K12 HD055931 - National Institutes of Health; UL1 TR000448 - National Institutes of Health

Undergraduate views of the structure and value of the Clemson general education ePortfolio

We gathered structural information about the Clemson general education eportfolio as well as students\u27 views of the ePortfolio\u27s educational, professional, and assessment values. Fifty-one students who had completed the ePortfolio were interviewed, and they reported minimum structural content (artifacts and rationales) in their ePortfolios. Participants rated the usefulness of the ePortfolio as very low. However, they rated the ePortfolios as accurately describing their capabilities significantly higher. Participants with a major program ePortfolio rated the values higher than those without. We are currently interviewing undergraduates who have not completed the ePortfolio to determine if their plans and expectations are more positive than students who have actually completed the ePortfolio

Comparative utility of the BESTest, mini-BESTest, and brief-BESTest for predicting falls in individuals with Parkinson disease: A cohort study

BACKGROUND: The newly developed Brief–Balance Evaluation System Test (Brief-BESTest) may be useful for measuring balance and predicting falls in individuals with Parkinson disease (PD). OBJECTIVES: The purposes of this study were: (1) to describe the balance performance of those with PD using the Brief-BESTest, (2) to determine the relationships among the scores derived from the 3 versions of the BESTest (ie, full BESTest, Mini-BESTest, and Brief-BESTest), and (3) to compare the accuracy of the Brief-BESTest with that of the Mini-BESTest and BESTest in identifying recurrent fallers among people with PD. DESIGN: This was a prospective cohort study. METHODS: Eighty participants with PD completed a baseline balance assessment. All participants reported a fall history during the previous 6 months. Fall history was again collected 6 months (n=51) and 12 months (n=40) later. RESULTS: At baseline, participants had varying levels of balance impairment, and Brief-BESTest scores were significantly correlated with Mini-BESTest (r=.94, P<.001) and BESTest (r=.95, P<.001) scores. Six-month retrospective fall prediction accuracy of the Brief-BESTest was moderately high (area under the curve [AUC]=0.82, sensitivity=0.76, and specificity=0.84). Prospective fall prediction accuracy over 6 months was similarly accurate (AUC=0.88, sensitivity=0.71, and specificity=0.87), but was less sensitive over 12 months (AUC=0.76, sensitivity=0.53, and specificity=0.93). LIMITATIONS: The sample included primarily individuals with mild to moderate PD. Also, there was a moderate dropout rate at 6 and 12 months. CONCLUSIONS: All versions of the BESTest were reasonably accurate in identifying future recurrent fallers, especially during the 6 months following assessment. Clinicians can reasonably rely on the Brief-BESTest for predicting falls, particularly when time and equipment constraints are of concern

Large Scale Cross-Correlations in Internet Traffic

The Internet is a complex network of interconnected routers and the existence of collective behavior such as congestion suggests that the correlations between different connections play a crucial role. It is thus critical to measure and quantify these correlations. We use methods of random matrix theory (RMT) to analyze the cross-correlation matrix C of information flow changes of 650 connections between 26 routers of the French scientific network `Renater'. We find that C has the universal properties of the Gaussian orthogonal ensemble of random matrices: The distribution of eigenvalues--up to a rescaling which exhibits a typical correlation time of the order 10 minutes--and the spacing distribution follow the predictions of RMT. There are some deviations for large eigenvalues which contain network-specific information and which identify genuine correlations between connections. The study of the most correlated connections reveals the existence of `active centers' which are exchanging information with a large number of routers thereby inducing correlations between the corresponding connections. These strong correlations could be a reason for the observed self-similarity in the WWW traffic.Comment: 7 pages, 6 figures, final versio