Rett syndrome: Establishing a novel outcome measure for walking activity in an era of clinical trials for rare disorders

Background: Rett syndrome is a pervasive neurological disorder with impaired gait as one criterion. This study investigated the capacity of three accelerometer-type devices to measure walking activity in Rett syndrome. Methods: Twenty-six participants (mean 18 years, SD 8) wore an Actigraph, ActivPAL and StepWatch Activity Monitor (SAM) during a video-taped session of activities. Agreement was determined between step-counts derived from each accelerometer and observation. Repeatability of SAM-derived step counts was determined using pairs of one-minute epochs during which the same participant was observed to walk with the same cadence. Results: The mean difference (limit of agreement) for the Actigraph, ActivPAL and SAM were −41 (SD 33), −16 (SD 21) and −1 (SD 16) steps/min, respectively. Agreement was influenced by a device/cadence interaction (p < 0.001) with greater under-recording at higher cadences. For SAM data, repeatability of step-count pairs was excellent (intraclass correlation coefficient 0.91, 95% CI 0.79–0.96). The standard error of measurement was 6 steps/min and we would be 95% confident that a change ≥17 steps/min would be greater than within-subject measurement error. Conclusions: The capacity of the SAM to measure physical activity in Rett syndrome allows focus on participation-based activities in clinical practice and clinical trials

Shark movement strategies influence poaching risk and can guide enforcement decisions in a large, remote Marine Protected Area

1. Large, remote marine protected areas (MPAs) containing both reef and pelagic habitats, have been shown to offer considerable refuge to populations of reef-associated sharks. Many large MPAs are, however, impacted by illegal fishing activity conducted by unlicensed vessels. While enforcement of these reserves is often expensive, it would likely benefit from the integration of ecological data on the mobile animals they are designed to protect. Consequently, shark populations in some protected areas continue to decline, as they remain a prime target for illegal fishers. 2. To understand shark movements and their vulnerability to illegal fishing, three years of acoustic tracking data, from 101 reef-associated sharks, were analysed as movement networks to explore the predictability of movement patterns and identify key movement corridors within the British Indian Ocean Territory (BIOT) MPA. We examined how space use and connectivity overlap with spatially-explicit risk of illegal fishing, through data obtained from the management consultancy enforcing the MPA. 3. Using individual-based models, the movement networks of two sympatric shark species were efficiently predicted with distance-decay functions (>95% movements accurately predicted). Model outliers were used to highlight the locations with unexpectedly high movement rates where MPA enforcement patrols might most efficiently mitigate predator removal. 4. Activity space estimates and network metrics illustrate that silvertip sharks were more dynamic, less resident and link larger components of the MPA than grey reef sharks. However, we show that this behaviour potentially enhances their exposure to illegal fishing activity. 5. Synthesis and applications. Marine protected area (MPA) enforcement strategies are often limited by resources. The British Indian Ocean Territory MPA, one of the world’s largest ‘no take’ MPAs, has a single patrol vessel to enforce 640,000 km2 of open ocean, atoll and reef ecosystems. We argue that to optimise the patrol vessel search strategy and thus enhance their protective capacity, ecological data on the space use and movements of desirable species, such as large-bodied reef predators, must be incorporated into management plans. Here, we use electronic tracking data to evaluate how shark movement dynamics influence species mortality trajectories in exploited reef ecosystems. In doing so we discuss how network analyses of such data might be applied for protected area enforcement

Analysing detection gaps in acoustic telemetry data to infer differential movement patterns in fish

A wide array of technologies are available for gaining insight into the movement of wild aquatic animals. Although acoustic telemetry can lack the fine‐scale spatial resolution of some satellite tracking technologies, the substantially longer battery life can yield important long‐term data on individual behavior and movement for low per‐unit cost. Typically, however, receiver arrays are designed to maximize spatial coverage at the cost of positional accuracy leading to potentially longer detection gaps as individuals move out of range between monitored locations. This is particularly true when these technologies are deployed to monitor species in hard‐to‐access locations. Here, we develop a novel approach to analyzing acoustic telemetry data, using the timing and duration of gaps between animal detections to infer different behaviors. Using the durations between detections at the same and different receiver locations (i.e., detection gaps), we classify behaviors into “restricted” or potential wider “out‐of‐range” movements synonymous with longer distance dispersal. We apply this method to investigate spatial and temporal segregation of inferred movement patterns in two sympatric species of reef shark within a large, remote, marine protected area (MPA). Response variables were generated using network analysis, and drivers of these movements were identified using generalized linear mixed models and multimodel inference. Species, diel period, and season were significant predictors of “out‐of‐range” movements. Silvertip sharks were overall more likely to undertake “out‐of‐range” movements, compared with gray reef sharks, indicating spatial segregation, and corroborating previous stable isotope work between these two species. High individual variability in “out‐of‐range” movements in both species was also identified. We present a novel gap analysis of telemetry data to help infer differential movement and space use patterns where acoustic coverage is imperfect and other tracking methods are impractical at scale. In remote locations, inference may be the best available tool and this approach shows that acoustic telemetry gap analysis can be used for comparative studies in fish ecology, or combined with other research techniques to better understand functional mechanisms driving behavior

Behavior and Ecology of Silky Sharks Around the Chagos Archipelago and Evidence of Indian Ocean Wide Movement

Silky sharks (Carcharhinus falciformis) represent a major component of global shark catch, both directly and as bycatch, and populations are declining as a result. An improved understanding of their movement ecology is needed to support conservation efforts. We deployed satellite and acoustic tags (2013-2018) and analysed historical fisheries records (1997-2009), to investigate the spatial ecology of silky sharks in the central Indian Ocean and a large Marine Protected Area (MPA; 640,000 km2) around the Chagos Archipelago. We observed high fidelity to the MPA, and a sustained diurnal association with a seamount complex, with individuals moving off at night and returning at sunrise. Yet, we also observed large-scale divergent movements in two satellite tagged individuals and documented the furthest recorded displacement distance for the species to date, with one individual moving from the MPA to the Kenyan coast – a displacement distance of 3,549 km (track distance ~4,782 km). Silky sharks undertook diel vertical migrations and oscillatory diving behaviour, spending >99% of their time in the top 100 m, and diving to depths of greater than 300 m, overlapping directly with typical deployments of purse seine and longline sets in the Indian Ocean. One individual was recorded to a depth of 1,112 m, the deepest recorded silky shark dive to date. Individuals spent 96% of their time at liberty within water temperatures between 24-30 °C. Historic fisheries data revealed that silky sharks were a major component of the shark community around the archipelago, representing 13.7% of all sharks caught by longlines before the fishery closed in 2010. Over half (55.9%) of all individuals caught by longlines and purse seiners were juveniles. The large proportion of juveniles, coupled with the high site fidelity and residence observed in some individuals, suggests that the MPA could provide considerable conservation benefits for silky sharks, particularly during early life-history stages. However, their high mobility potential necessitates that large MPAs need to be considered in conjunction with fisheries regulations and conservation measures in adjacent EEZs and in areas beyond national jurisdiction

Distances from Surface Brightness Fluctuations

The practice of measuring galaxy distances from their spatial fluctuations in surface brightness is now a decade old. While several past articles have included some review material, this is the first intended as a comprehensive review of the surface brightness fluctuation (SBF) method. The method is conceptually quite simple, the basic idea being that nearby (but unresolved) star clusters and galaxies appear "bumpy", while more distant ones appear smooth. This is quantified via a measurement of the amplitude of the Poisson fluctuations in the number of unresolved stars encompassed by a CCD pixel (usually in an image of an elliptical galaxy). Here, we describe the technical details and difficulties involved in making SBF measurements, discuss theoretical and empirical calibrations of the method, and review the numerous applications of the method from the ground and space, in the optical and near-infrared. We include discussions of stellar population effects and the "universality" of the SBF standard candle. A final section considers the future of the method.Comment: Invited review article to appear in: `Post-Hipparcos Cosmic Candles', A. Heck & F. Caputo (Eds), Kluwer Academic Publ., Dordrecht, in press. 22 pages, including 3 postscript figures; uses Kluwer's crckapb.sty LaTex macro file, enclose

Task-oriented evaluation of electronic medical records systems: development and validation of a questionnaire for physicians

BACKGROUND: Evaluation is a challenging but necessary part of the development cycle of clinical information systems like the electronic medical records (EMR) system. It is believed that such evaluations should include multiple perspectives, be comparative and employ both qualitative and quantitative methods. Self-administered questionnaires are frequently used as a quantitative evaluation method in medical informatics, but very few validated questionnaires address clinical use of EMR systems. METHODS: We have developed a task-oriented questionnaire for evaluating EMR systems from the clinician's perspective. The key feature of the questionnaire is a list of 24 general clinical tasks. It is applicable to physicians of most specialties and covers essential parts of their information-oriented work. The task list appears in two separate sections, about EMR use and task performance using the EMR, respectively. By combining these sections, the evaluator may estimate the potential impact of the EMR system on health care delivery. The results may also be compared across time, site or vendor. This paper describes the development, performance and validation of the questionnaire. Its performance is shown in two demonstration studies (n = 219 and 80). Its content is validated in an interview study (n = 10), and its reliability is investigated in a test-retest study (n = 37) and a scaling study (n = 31). RESULTS: In the interviews, the physicians found the general clinical tasks in the questionnaire relevant and comprehensible. The tasks were interpreted concordant to their definitions. However, the physicians found questions about tasks not explicitly or only partially supported by the EMR systems difficult to answer. The two demonstration studies provided unambiguous results and low percentages of missing responses. In addition, criterion validity was demonstrated for a majority of task-oriented questions. Their test-retest reliability was generally high, and the non-standard scale was found symmetric and ordinal. CONCLUSION: This questionnaire is relevant for clinical work and EMR systems, provides reliable and interpretable results, and may be used as part of any evaluation effort involving the clinician's perspective of an EMR system

Consumer perceptions of co-branding alliances: Organizational dissimilarity signals and brand fit

This study explores how consumers evaluate co-branding alliances between dissimilar partner firms. Customers are well aware that different firms are behind a co-branded product and observe the partner firms’ characteristics. Drawing on signaling theory, we assert that consumers use organizational characteristics as signals in their assessment of brand fit and for their purchasing decisions. Some organizational signals are beyond the control of the co-branding partners or at least they cannot alter them on short notice. We use a quasi-experimental design and test how co-branding partner dissimilarity affects brand fit perception. The results show that co-branding partner dissimilarity in terms of firm size, industry scope, and country-of-origin image negatively affects brand fit perception. Firm age dissimilarity does not exert significant influence. Because brand fit generally fosters a benevolent consumer attitude towards a co-branding alliance, the findings suggest that high partner dissimilarity may reduce overall co-branding alliance performance

Adult-Age Inflammatory Pain Experience Enhances Long-Term Pain Vigilance in Rats

Background: Previous animal studies have illustrated a modulatory effect of neonatal pain experience on subsequent painrelated behaviors. However, the relationship between chronic pain status in adulthood and future pain perception remains unclear. Methodology/Principal Findings: In the current study, we investigated the effects of inflammatory pain experience on subsequent formalin-evoked pain behaviors and fear conditioning induced by noxious stimulation in adult rats. Our results demonstrated an increase of the second but not the first phase of formalin-induced pain behaviors in animals with a history of inflammatory pain that have recovered. Similarly, rats with persistent pain experience displayed facilitated acquisition and prolonged retention of pain-related conditioning. These effects of prior pain experience on subsequent behavior were prevented by repeated morphine administration at an early stage of inflammatory pain. Conclusions/Significance: These results suggest that chronic pain diseases, if not properly and promptly treated, may have a long-lasting impact on processing and perception of environmental threats. This may increase the susceptibility of patients to subsequent pain-related disorders, even when chronic pain develops in adulthood. These data highlight th

Activation of the SPHK/S1P signalling pathway is coupled to muscarinic receptor-dependent regulation of peripheral airways

BACKGROUND: In peripheral airways, acetylcholine induces contraction via activation of muscarinic M2-and M3-receptor subtypes (M(2)R and M(3)R). Cholinergic hypersensitivity is associated with chronic obstructive pulmonary disease and asthma, and therefore the identification of muscarinic signaling pathways are of great therapeutic interest. A pathway that has been shown to be activated via MR and to increase [Ca(2+)](i )includes the activation of sphingosine kinases (SPHK) and the generation of the bioactive sphingolipid sphingosine 1-phosphate (S1P). Whether the SPHK/S1P signaling pathway is integrated in the muscarinic control of peripheral airways is not known. METHODS: To address this issue, we studied precision cut lung slices derived from FVB and M(2)R-KO and M(3)R-KO mice. RESULTS: In peripheral airways of FVB, wild-type, and MR-deficient mice, SPHK1 was mainly localized to smooth muscle. Muscarine induced a constriction in all investigated mouse strains which was reduced by inhibition of SPHK using D, L-threo-dihydrosphingosine (DHS) and N, N-dimethyl-sphingosine (DMS) but not by N-acetylsphingosine (N-AcS), a structurally related agent that does not affect SPHK function. The initial phase of constriction was nearly absent in peripheral airways of M(3)R-KO mice when SPHK was inhibited by DHS and DMS but was unaffected in M(2)R-KO mice. Quantitative RT-PCR revealed that the disruption of the M(2)R and M(3)R genes had no significant effect on the expression levels of the SPHK1-isoform in peripheral airways. CONCLUSION: These results demonstrate that the SPHK/S1P signaling pathway contributes to cholinergic constriction of murine peripheral airways. In addition, our data strongly suggest that SPHK is activated via the M(2)R. Given the important role of muscarinic mechanisms in pulmonary disease, these findings should be of considerable therapeutic relevance

Is Intracranial Atherosclerosis an Independent Risk Factor for Cerebral Atrophy? A Retrospective Evaluation

<p>Abstract</p> <p>Background</p> <p>Our purpose was to study the association between the intracranial atherosclerosis as measured by cavernous carotid artery calcification (ICAC) observed on head CT and atrophic changes of supra-tentorial brain demonstrated by MRI.</p> <p>Methods</p> <p>Institutional review board approval was obtained for this retrospective study incorporating 65 consecutive patients presenting acutely who had both head CT and MRI. Arterial calcifications of the intracranial cavernous carotids (ICAC) were assigned a number (1 to 4) in the bone window images from CT scans. These 4 groups were then combined into high (grades 3 and 4) and low calcium (grades 1 and 2) subgroups. Brain MRI was independently evaluated to identify cortical and central atrophy. Demographics and cardiovascular risk factors were evaluated in subjects with high and low ICAC. Relationship between CT demonstrated ICAC and brain atrophy patterns were evaluated both without and with adjustment for cerebral ischemic scores and cardiovascular risk factors.</p> <p>Results</p> <p>Forty-six of the 65 (71%) patients had high ICAC on head CT. Subjects with high ICAC were older, and had higher prevalence of hypertension, diabetes, coronary artery disease (CAD), atrial fibrillation and history of previous stroke (CVA) compared to those with low ICAC. Age demonstrated strong correlation with both supratentorial atrophy patterns. There was no correlation between ICAC and cortical atrophy. There was correlation however between central atrophy and ICAC. This persisted even after adjustment for age.</p> <p>Conclusion</p> <p>Age is the most important determinant of atrophic cerebral changes. However, high ICAC demonstrated age independent association with central atrophy.</p