A practical guide to troubleshooting pallidal deep brain stimulation issues in patients with dystonia

High frequency deep brain stimulation (DBS) of the internal portion of the globus pallidus has, in the last two decades, become a mainstream therapy for the management of medically-refractory dystonia syndromes. Such increasing uptake places an onus on movement disorder physicians to become familiar with this treatment modality, in particular optimal patient selection for the procedure and how to troubleshoot problems relating to sub-optimal efficacy and therapy-related side effects. Deep brain stimulation for dystonic conditions presents some unique challenges. For example, the frequent lack of immediate change in clinical status following stimulation alterations means that programming often relies on personal experience and local practice rather than real-time indicators of efficacy. Further, dystonia is a highly heterogeneous disorder, making the development of unifying guidelines and programming algorithms for DBS in this population difficult. Consequently, physicians may feel less confident in managing DBS for dystonia as compared to other indications e.g. Parkinson's disease. In this review, we integrate our years of personal experience of the programming of DBS systems for dystonia with a critical appraisal of the literature to produce a practical guide for troubleshooting common issues encountered in patients with dystonia treated with DBS, in the hope of improving the care for these patients

The XXL Survey X: K-band luminosity - weak-lensing mass relation for groups and clusters of galaxies

We present the K-band luminosity-halo mass relation, $L_{K,500}-M_{500,WL}$, for a subsample of 20 of the 100 brightest clusters in the XXL Survey observed with WIRCam at the Canada-France-Hawaii Telescope (CFHT). For the first time, we have measured this relation via weak-lensing analysis down to $M_{500,WL} =3.5 \times 10^{13}\,M_\odot$. This allows us to investigate whether the slope of the $L_K-M$ relation is different for groups and clusters, as seen in other works. The clusters in our sample span a wide range in mass, $M_{500,WL} =0.35-12.10 \times 10^{14}\,M_\odot$, at $0<z<0.6$. The K-band luminosity scales as $\log_{10}(L_{K,500}/10^{12}L_\odot) \propto \beta log_{10}(M_{500,WL}/10^{14}M_\odot)$ with $\beta = 0.85^{+0.35}_{-0.27}$ and an intrinsic scatter of $\sigma_{lnL_K|M} =0.37^{+0.19}_{-0.17}$. Combining our sample with some clusters in the Local Cluster Substructure Survey (LoCuSS) present in the literature, we obtain a slope of $1.05^{+0.16}_{-0.14}$ and an intrinsic scatter of $0.14^{+0.09}_{-0.07}$. The flattening in the $L_K-M$ seen in previous works is not seen here and might be a result of a bias in the mass measurement due to assumptions on the dynamical state of the systems. We also study the richness-mass relation and find that group-sized halos have more galaxies per unit halo mass than massive clusters. However, the brightest cluster galaxy (BCG) in low-mass systems contributes a greater fraction to the total cluster light than BCGs do in massive clusters; the luminosity gap between the two brightest galaxies is more prominent for group-sized halos. This result is a natural outcome of the hierarchical growth of structures, where massive galaxies form and gain mass within low-mass groups and are ultimately accreted into more massive clusters to become either part of the BCG or one of the brighter galaxies. [Abridged]Comment: A&A, in pres

Multi-Site Identification and Generalization of Clusters of Walking Behaviors in Individuals With Chronic Stroke and Neurotypical Controls

Background Walking patterns in stroke survivors are highly heterogeneous, which poses a challenge in systematizing treatment prescriptions for walking rehabilitation interventions. Objectives We used bilateral spatiotemporal and force data during walking to create a multi-site research sample to: (1) identify clusters of walking behaviors in people post-stroke and neurotypical controls and (2) determine the generalizability of these walking clusters across different research sites. We hypothesized that participants post-stroke will have different walking impairments resulting in different clusters of walking behaviors, which are also different from control participants. Methods We gathered data from 81 post-stroke participants across 4 research sites and collected data from 31 control participants. Using sparse K-means clustering, we identified walking clusters based on 17 spatiotemporal and force variables. We analyzed the biomechanical features within each cluster to characterize cluster-specific walking behaviors. We also assessed the generalizability of the clusters using a leave-one-out approach. Results We identified 4 stroke clusters: a fast and asymmetric cluster, a moderate speed and asymmetric cluster, a slow cluster with frontal plane force asymmetries, and a slow and symmetric cluster. We also identified a moderate speed and symmetric gait cluster composed of controls and participants post-stroke. The moderate speed and asymmetric stroke cluster did not generalize across sites. Conclusions Although post-stroke walking patterns are heterogenous, these patterns can be systematically classified into distinct clusters based on spatiotemporal and force data. Future interventions could target the key features that characterize each cluster to increase the efficacy of interventions to improve mobility in people post-stroke

Improving mortality rate estimates for management of the Queensland saucer scallop fishery

This research was undertaken on the Queensland saucer scallop (Ylistrum balloti) fishery in southeast Queensland, which is an important component of the Queensland East Coast Otter Trawl Fishery (QECOTF). The research was undertaken by a collaborative team from the Queensland Department of Agriculture and Fisheries, James Cook University (JCU) and the Centre for Applications in Natural Resource Mathematics (CARM), University of Queensland and focused on 1) an annual fishery-independent trawl survey of scallop abundance, 2) relationships between scallop abundance and physical properties of the seafloor, and 3) deriving an updated estimate of the scallop’s natural mortality rate. The scallop fishery used to be one of the state’s most valuable commercially fished stocks with the annual catch peak at just under 2000 t (adductor muscle meat-weight) in 1993 valued at about $30 million, but in recent years the stock has declined and is currently considered to be overfished. Results from the study are used to improve monitoring, stock assessment and management advice for the fishery

Longitudinal Synaptic Loss in Primary Tauopathies: An In Vivo [11 C]UCB-J Positron Emission Tomography Study

BACKGROUND: Synaptic loss is characteristic of many neurodegenerative diseases; it occurs early and is strongly related to functional deficits. OBJECTIVE: In this longitudinal observational study, we determine the rate at which synaptic density is reduced in the primary tauopathies of progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD), and we test the relationship with disease progression. METHODS: Our cross-sectional cohort included 32 participants with probable PSP and 16 with probable CBD (all amyloid-negative corticobasal syndrome), recruited from tertiary care centers in the United Kingdom, and 33 sex- and age-matched healthy control subjects. Synaptic density was estimated by positron emission tomography imaging with the radioligand [11 C]UCB-J that binds synaptic vesicle 2A. Clinical severity and cognition were assessed by the PSP Rating Scale and the Addenbrooke's cognitive examination. Regional [11 C]UCB-J nondisplaceable binding potential was estimated in Hammersmith Atlas regions of interest. Twenty-two participants with PSP/CBD had a follow-up [11 C]UCB-J positron emission tomography scan after 1 year. We calculated the annualized change in [11 C]UCB-J nondisplaceable binding potential and correlated this with the change in clinical severity. RESULTS: We found significant annual synaptic loss within the frontal lobe (-3.5%, P = 0.03) and the right caudate (-3.9%, P = 0.046). The degree of longitudinal synaptic loss within the frontal lobe correlated with the rate of change in the PSP Rating Scale (R = 0.47, P = 0.03) and cognition (Addenbrooke's Cognitive Examination-Revised, R = -0.62, P = 0.003). CONCLUSIONS: We provide in vivo evidence for rapid progressive synaptic loss, correlating with clinical progression in primary tauopathies. Synaptic loss may be an important therapeutic target and outcome variable for early-phase clinical trials of disease-modifying treatments. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

LoCuSS: Testing hydrostatic equilibrium in galaxy clusters

We test the assumption of hydrostatic equilibrium in an X-ray luminosity selected sample of 50 galaxy clusters at $0.15<z<0.3$ from the Local Cluster Substructure Survey (LoCuSS). Our weak-lensing measurements of $M_{500}$ control systematic biases to sub-4 per cent, and our hydrostatic measurements of the same achieve excellent agreement between XMM-Newton and Chandra. The mean ratio of X-ray to lensing mass for these 50 clusters is $\beta_{\rm X}=0.95\pm0.05$, and for the 44 clusters also detected by Planck, the mean ratio of Planck mass estimate to LoCuSS lensing mass is $\beta_{\rm P}=0.95\pm0.04$. Based on a careful like-for-like analysis, we find that LoCuSS, the Canadian Cluster Comparison Project (CCCP), and Weighing the Giants (WtG) agree on $\beta_{\rm P}\simeq0.9-0.95$ at $0.15<z<0.3$. This small level of hydrostatic bias disagrees at $\sim5\sigma$ with the level required to reconcile Planck cosmology results from the cosmic microwave background and galaxy cluster counts

Continuing Medical Education as a Translational Science Opportunity for Health Communication Researchers: The BCERP Model

Health communication researchers often work across health issues to engage in research that bridges distance between bench scientists and practitioners. This translational activity is essential to increase the likelihood that emerging science from the laboratory makes it into the hands of health professionals who can integrate it into their everyday practice with patients. An underutilized translational approach by communication researchers is the development of continuing medical education (CME) opportunities that incorporate a communication science approach to the uptake of recommended practices based on emerging science. This manuscript explains the nature of translational science, highlights the role of CME as an integral strategy for engaging in it, and then provides the exemplar of a training and evaluation project funded by the National Institute for Environmental Health Sciences for the Breast Cancer and the Environment Research Program (BCERP). Lessons learned are discussed as they relate to developing a translational opportunity for the BCERP