Neonatal Diagnostics: Toward Dynamic Growth Charts of Neuromotor Control

© 2016 Torres, Smith, Mistry, Brincker and Whyatt. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).The current rise of neurodevelopmental disorders poses a critical need to detect risk early in order to rapidly intervene. One of the tools pediatricians use to track development is the standard growth chart. The growth charts are somewhat limited in predicting possible neurodevelopmental issues. They rely on linear models and assumptions of normality for physical growth data – obscuring key statistical information about possible neurodevelopmental risk in growth data that actually has accelerated, non-linear rates-of-change and variability encompassing skewed distributions. Here, we use new analytics to profile growth data from 36 newborn babies that were tracked longitudinally for 5 months. By switching to incremental (velocity-based) growth charts and combining these dynamic changes with underlying fluctuations in motor performance – as the transition from spontaneous random noise to a systematic signal – we demonstrate a method to detect very early stunting in the development of voluntary neuromotor control and to flag risk of neurodevelopmental derail.Peer reviewedFinal Published versio

Stochastic signatures of involuntary head micro-movements can be used to classify females of ABIDE into different subtypes of neurodevelopmental disorders.

© 2017 Torres, Mistry, Caballero and Whyatt. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).Background: The approximate 5:1 male to female ratio in clinical detection of Autism Spectrum Disorder (ASD) prevents research from characterizing the female phenotype. Current open access repositories [such as those in the Autism Brain Imaging Data Exchange (ABIDE I-II)] contain large numbers of females to help begin providing a new characterization of females on the autistic spectrum. Here we introduce new methods to integrate data in a scale-free manner from continuous biophysical rhythms of the nervous systems and discrete (ordinal) observational scores. Methods: New data-types derived from image-based involuntary head motions and personalized statistical platform were combined with a data-driven approach to unveil sub-groups within the female cohort. Further, to help refine the clinical DSM-based ASD vs. Asperger's Syndrome (AS) criteria, distributional analyses of ordinal score data from Autism Diagnostic Observation Schedule (ADOS)-based criteria were used on both the female and male phenotypes. Results: Separate clusters were automatically uncovered in the female cohort corresponding to differential levels of severity. Specifically, the AS-subgroup emerged as the most severely affected with an excess level of noise and randomness in the involuntary head micro-movements. Extending the methods to characterize males of ABIDE revealed ASD-males to be more affected than AS-males. A thorough study of ADOS-2 and ADOS-G scores provided confounding results regarding the ASD vs. AS male comparison, whereby the ADOS-2 rendered the AS-phenotype worse off than the ASD-phenotype, while ADOS-G flipped the results. Females with AS scored higher on severity than ASD-females in all ADOS test versions and their scores provided evidence for significantly higher severity than males. However, the statistical landscapes underlying female and male scores appeared disparate. As such, further interpretation of the ADOS data seems problematic, rather suggesting the critical need to develop an entirely new metric to measure social behavior in females. Conclusions: According to the outcome of objective, data-driven analyses and subjective clinical observation, these results support the proposition that the female phenotype is different. Consequently the “social behavioral male ruler” will continue to mask the female autistic phenotype. It is our proposition that new observational behavioral tests ought to contain normative scales, be statistically sound and combined with objective data-driven approaches to better characterize the females across the human lifespan.Peer reviewe

State-of-the-art methods for exposure-health studies: Results from the exposome data challenge event

The exposome recognizes that individuals are exposed simultaneously to a multitude of different environmental factors and takes a holistic approach to the discovery of etiological factors for disease. However, challenges arise when trying to quantify the health effects of complex exposure mixtures. Analytical challenges include dealing with high dimensionality, studying the combined effects of these exposures and their interactions, integrating causal pathways, and integrating high-throughput omics layers. To tackle these challenges, the Barcelona Institute for Global Health (ISGlobal) held a data challenge event open to researchers from all over the world and from all expertises. Analysts had a chance to compete and apply state-of-the-art methods on a common partially simulated exposome dataset (based on real case data from the HELIX project) with multiple correlated exposure variables (P > 100 exposure variables) arising from general and personal environments at different time points, biological molecular data (multi-omics: DNA methylation, gene expression, proteins, metabolomics) and multiple clinical phenotypes in 1301 mother–child pairs. Most of the methods presented included feature selection or feature reduction to deal with the high dimensionality of the exposome dataset. Several approaches explicitly searched for combined effects of exposures and/or their interactions using linear index models or response surface methods, including Bayesian methods. Other methods dealt with the multi-omics dataset in mediation analyses using multiple-step approaches. Here we discuss features of the statistical models used and provide the data and codes used, so that analysts have examples of implementation and can learn how to use these methods. Overall, the exposome data challenge presented a unique opportunity for researchers from different disciplines to create and share state-of-the-art analytical methods, setting a new standard for open science in the exposome and environmental health field

Methodologies for Assessing the Acceptability of Oral Formulations among children and older adults: A Systematic Review

This is an open access article distributed under the terms and conditions of the Creative Commons Attribution NonCommercial-NoDerivatives 4.0 International CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/Acceptability of medicinal products in children and older populations is pivotal in ensuring adherence and therapeutic outcomes. This review systematically identifies studies reporting on formulation aspects of oral medications that affect their acceptability in these patient groups. Particular emphasis is placed on the evaluation of the methodologies employed in the studies. Sixty-eight studies were included for analysis, with 51 (75%) in children and 17 (25%) in older populations. The studies evaluated a range of oral formulations; however, the methodologies used differ considerably in participants’ characteristics, study settings, tools, acceptability definitions and criteria. It is evident that there is a lack of standardisation in study design as well as the assessment methods used in assessing acceptability of medicines in children and older populations. This review presents a systematic analysis on methods employed for assessing acceptability of oral medicines in children and older adults, to provide insights and recommendations regarding the design of reliable instruments in future studies.Peer reviewe

Clinical Subtypes of Depression Are Associated with Specific Metabolic Parameters and Circadian Endocrine Profiles in Women: The Power Study

Major depressive disorder (MDD) has been associated with adverse medical consequences, including cardiovascular disease and osteoporosis. Patients with MDD may be classified as having melancholic, atypical, or undifferentiated features. The goal of the present study was to assess whether these clinical subtypes of depression have different endocrine and metabolic features and consequently, varying medical outcomes.Premenopausal women, ages 21 to 45 years, with MDD (N = 89) and healthy controls (N = 44) were recruited for a prospective study of bone turnover. Women with MDD were classified as having melancholic (N = 51), atypical (N = 16), or undifferentiated (N = 22) features. Outcome measures included: metabolic parameters, body composition, bone mineral density (BMD), and 24 hourly sampling of plasma adrenocorticotropin (ACTH), cortisol, and leptin.Compared with control subjects, women with undifferentiated and atypical features of MDD exhibited greater BMI, waist/hip ratio, and whole body and abdominal fat mass. Women with undifferentiated MDD characteristics also had higher lipid and fasting glucose levels in addition to a greater prevalence of low BMD at the femoral neck compared to controls. Elevated ACTH levels were demonstrated in women with atypical features of depression, whereas higher mean 24-hour leptin levels were observed in the melancholic subgroup.Pre-menopausal women with various features of MDD exhibit metabolic, endocrine, and BMD features that may be associated with different health consequences.ClinicalTrials.gov NCT00006180

Aging with Autism Departs Greatly from Typical Aging

Autism has been largely portrayed as a psychiatric and childhood disorder. However, autism is a lifelong neurological condition that evolves over time through highly heterogeneous trajectories. These trends have not been studied in relation to normative aging trajectories, so we know very little about aging with autism. One aspect that seems to develop differently is the sense of movement, inclusive of sensory kinesthetic-reafference emerging from continuously sensed self-generated motions. These include involuntary micro-motions eluding observation, yet routinely obtainable in fMRI studies to rid images of motor artifacts. Open-access repositories offer thousands of imaging records, covering 5–65 years of age for both neurotypical and autistic individuals to ascertain the trajectories of involuntary motions. Here we introduce new computational techniques that automatically stratify different age groups in autism according to probability distance in different representational spaces. Further, we show that autistic cross-sectional population trajectories in probability space fundamentally differ from those of neurotypical controls and that after 40 years of age, there is an inflection point in autism, signaling a monotonically increasing difference away from age-matched normative involuntary motion signatures. Our work offers new age-appropriate stochastic analyses amenable to redefine basic research and provide dynamic diagnoses as the person’s nervous systems age

DataSheet2.docx

<p>The variability inherently present in biophysical data is partly contributed by disparate sampling resolutions across instrumentations. This poses a potential problem for statistical inference using pooled data in open access repositories. Such repositories combine data collected from multiple research sites using variable sampling resolutions. One example is the Autism Brain Imaging Data Exchange repository containing thousands of imaging and demographic records from participants in the spectrum of autism and age-matched neurotypical controls. Further, statistical analyses of groups from different diagnoses and demographics may be challenging, owing to the disparate number of participants across different clinical subgroups. In this paper, we examine the noise signatures of head motion data extracted from resting state fMRI data harnessed under different sampling resolutions. We characterize the quality of the noise in the variability of the raw linear and angular speeds for different clinical phenotypes in relation to age-matched controls. Further, we use bootstrapping methods to ensure compatible group sizes for statistical comparison and report the ranges of physical involuntary head excursions of these groups. We conclude that different sampling rates do affect the quality of noise in the variability of head motion data and, consequently, the type of random process appropriate to characterize the time series data. Further, given a qualitative range of noise, from pink to brown noise, it is possible to characterize different clinical subtypes and distinguish them in relation to ranges of neurotypical controls. These results may be of relevance to the pre-processing stages of the pipeline of analyses of resting state fMRI data, whereby head motion enters the criteria to clean imaging data from motion artifacts.</p

Characterization of Noise Signatures of Involuntary Head Motion in the Autism Brain Imaging Data Exchange Repository

The variability inherently present in biophysical data is partly contributed by disparate sampling resolutions across instrumentations. This poses a potential problem for statistical inference using pooled data in open access repositories. Such repositories combine data collected from multiple research sites using variable sampling resolutions. One example is the Autism Brain Imaging Data Exchange repository containing thousands of imaging and demographic records from participants in the spectrum of autism and age-matched neurotypical controls. Further, statistical analyses of groups from different diagnoses and demographics may be challenging, owing to the disparate number of participants across different clinical subgroups. In this paper, we examine the noise signatures of head motion data extracted from resting state fMRI data harnessed under different sampling resolutions. We characterize the quality of the noise in the variability of the raw linear and angular speeds for different clinical phenotypes in relation to age-matched controls. Further, we use bootstrapping methods to ensure compatible group sizes for statistical comparison and report the ranges of physical involuntary head excursions of these groups. We conclude that different sampling rates do affect the quality of noise in the variability of head motion data and, consequently, the type of random process appropriate to characterize the time series data. Further, given a qualitative range of noise, from pink to brown noise, it is possible to characterize different clinical subtypes and distinguish them in relation to ranges of neurotypical controls. These results may be of relevance to the pre-processing stages of the pipeline of analyses of resting state fMRI data, whereby head motion enters the criteria to clean imaging data from motion artifacts