The Real-World Experiences of Persons With Multiple Sclerosis During the First COVID-19 Lockdown: Application of Natural Language Processing.

The increasing availability of "real-world" data in the form of written text holds promise for deepening our understanding of societal and health-related challenges. Textual data constitute a rich source of information, allowing the capture of lived experiences through a broad range of different sources of information (eg, content and emotional tone). Interviews are the "gold standard" for gaining qualitative insights into individual experiences and perspectives. However, conducting interviews on a large scale is not always feasible, and standardized quantitative assessment suitable for large-scale application may miss important information. Surveys that include open-text assessments can combine the advantages of both methods and are well suited for the application of natural language processing (NLP) methods. While innovations in NLP have made large-scale text analysis more accessible, the analysis of real-world textual data is still complex and requires several consecutive steps. We developed and subsequently examined the utility and scientific value of an NLP pipeline for extracting real-world experiences from textual data to provide guidance for applied researchers. We applied the NLP pipeline to large-scale textual data collected by the Swiss Multiple Sclerosis (MS) registry. Such textual data constitute an ideal use case for the study of real-world text data. Specifically, we examined 639 text reports on the experienced impact of the first COVID-19 lockdown from the perspectives of persons with MS. The pipeline has been implemented in Python and complemented by analyses of the "Linguistic Inquiry and Word Count" software. It consists of the following 5 interconnected analysis steps: (1) text preprocessing; (2) sentiment analysis; (3) descriptive text analysis; (4) unsupervised learning-topic modeling; and (5) results interpretation and validation. A topic modeling analysis identified the following 4 distinct groups based on the topics participants were mainly concerned with: "contacts/communication;" "social environment;" "work;" and "errands/daily routines." Notably, the sentiment analysis revealed that the "contacts/communication" group was characterized by a pronounced negative emotional tone underlying the text reports. This observed heterogeneity in emotional tonality underlying the reported experiences of the first COVID-19-related lockdown is likely to reflect differences in emotional burden, individual circumstances, and ways of coping with the pandemic, which is in line with previous research on this matter. This study illustrates the timely and efficient applicability of an NLP pipeline and thereby serves as a precedent for applied researchers. Our study thereby contributes to both the dissemination of NLP techniques in applied health sciences and the identification of previously unknown experiences and burdens of persons with MS during the pandemic, which may be relevant for future treatment

Diagnostic applications of molecular and serological assays for bluetongue and African horse sickness

The availability of rapid, highly sensitive and specific molecular and serologic diagnostic assays, such as competitive enzyme-linked immunosorbent assay (cELISA), has expedited the diagnosis of emerging transboundary animal diseases, including bluetongue (BT) and African horse sickness (AHS), and facilitated more thorough characterisation of their epidemiology. The development of assays based on real-time, reverse-transcription polymerase chain reaction (RT-PCR) to detect and identify the numerous serotypes of BT virus (BTV) and AHS virus (AHSV) has aided in-depth studies of the epidemiology of BTV infection in California and AHSV infection in South Africa. The subsequent evaluation of pan-serotype, real-time, RT-PCR-positive samples through the use of serotype-specific RT-PCR assays allows the rapid identification of virus serotypes, reducing the need for expensive and time-consuming conventional methods, such as virus isolation and serotype-specific virus neutralisation assays. These molecular assays and cELISA platforms provide tools that have enhanced epidemiologic surveillance strategies and improved our understanding of potentially altered Culicoides midge behaviour when infected with BTV. They have also supported the detection of subclinical AHSV infection of vaccinated horses in South Africa. Moreover, in conjunction with whole genome sequence analysis, these tests have clarified that the mechanism behind recent outbreaks of AHS in the AHS-controlled area of South Africa was the result of the reversion to virulence and/or genome reassortment of live attenuated vaccine viruses. This review focuses on the use of contemporary molecular diagnostic assays in the context of recent epidemiologic studies and explores their advantages over historic virus isolation and serologic techniques.https://www.woah.org/en/what-we-do/publications/scientific-and-technical-reviewVeterinary Tropical Disease

Factors associated with time from first-symptoms to diagnosis and treatment initiation of Multiple Sclerosis in Switzerland.

Recent studies emphasise the importance of timely diagnosis and early initiation of disease-modifying treatment in the long-term prognosis of multiple sclerosis. The objective of this study was to investigate factors associated with extended time to diagnosis and time to disease-modifying treatment initiation in the Swiss Multiple Sclerosis Registry. We used retrospective data (diagnoses 1996-2017) of the survey-based Swiss Multiple Sclerosis Registry and fitted logistic regression models (extended time to diagnosis ≥2 years from first symptoms, extended time to disease-modifying treatment initiation ≥1 year from diagnosis) with demographic and a priori defined variables. Our study, based on 996 persons with multiple sclerosis, suggests that 40% had an extended time to diagnosis, and extended time to disease-modifying treatment initiation was seen in 23%. Factors associated with extended time to diagnosis were primary progressive multiple sclerosis (odds ratio (OR) 5.09 (3.12-8.49)), diagnosis setting outside of hospital (neurologist (private practice) OR 1.54 (1.16-2.05)) and more uncommon first symptoms (per additional symptom OR 1.17 (1.06-1.30)). Older age at onset (per additional 5 years OR 0.84 (0.78-0.90)) and gait problems (OR 0.65 (0.47-0.89)) or paresthesia (OR 0.72 (0.54-0.95)) as first symptoms were associated with shorter time to diagnosis. Extended time to disease-modifying treatment initiation was associated with older age at diagnosis (per additional 5 years OR 1.18 (1.09-1.29)). In more recent years, time to diagnosis and time to disease-modifying treatment initiation tended to be shorter. Even in recent periods, substantial and partially systematic variation regarding time to diagnosis and time to disease-modifying treatment initiation remains. With the emerging paradigm of early treatment, the residual variation should be monitored carefully

Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial)

BACKGROUND: Falls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention. DESIGN: Pragmatic cohort randomised controlled trial in England and Ireland. 1010 participants were randomised (493 to the Intervention group and 517 to Usual Care) to either: a podiatry intervention, including foot and ankle exercises, foot orthoses and, if required, new footwear, and a falls prevention leaflet or usual podiatry treatment plus a falls prevention leaflet. The primary outcome was the incidence rate of self-reported falls per participant in the 12 months following randomisation. Secondary outcomes included: proportion of fallers and those reporting multiple falls, time to first fall, fear of falling, Frenchay Activities Index, Geriatric Depression Scale, foot pain, health related quality of life, and cost-effectiveness. RESULTS: In the primary analysis were 484 (98.2%) intervention and 507 (98.1%) control participants. There was a small, non statistically significant reduction in the incidence rate of falls in the intervention group (adjusted incidence rate ratio 0.88, 95% CI 0.73 to 1.05, p = 0.16). The proportion of participants experiencing a fall was lower (49.7 vs 54.9%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00, p = 0.05) as was the proportion experiencing two or more falls (27.6% vs 34.6%, adjusted odds ratio 0.69, 95% CI 0.52 to 0.90, p = 0.01). There was an increase (p = 0.02) in foot pain for the intervention group. There were no statistically significant differences in other outcomes. The intervention was more costly but marginally more beneficial in terms of health-related quality of life (mean quality adjusted life year (QALY) difference 0.0129, 95% CI -0.0050 to 0.0314) and had a 65% probability of being cost-effective at a threshold of £30,000 per QALY gained. CONCLUSION: There was a small reduction in falls. The intervention may be cost-effective. TRIAL REGISTRATION: ISRCTN ISRCTN68240461

The composition of the protosolar disk and the formation conditions for comets

Conditions in the protosolar nebula have left their mark in the composition of cometary volatiles, thought to be some of the most pristine material in the solar system. Cometary compositions represent the end point of processing that began in the parent molecular cloud core and continued through the collapse of that core to form the protosun and the solar nebula, and finally during the evolution of the solar nebula itself as the cometary bodies were accreting. Disentangling the effects of the various epochs on the final composition of a comet is complicated. But comets are not the only source of information about the solar nebula. Protostellar disks around young stars similar to the protosun provide a way of investigating the evolution of disks similar to the solar nebula while they are in the process of evolving to form their own solar systems. In this way we can learn about the physical and chemical conditions under which comets formed, and about the types of dynamical processing that shaped the solar system we see today. This paper summarizes some recent contributions to our understanding of both cometary volatiles and the composition, structure and evolution of protostellar disks.Comment: To appear in Space Science Reviews. The final publication is available at Springer via http://dx.doi.org/10.1007/s11214-015-0167-

Subcritical multiplicative chaos for regularized counting statistics from random matrix theory

For an N×N random unitary matrix U_N, we consider the random field defined by counting the number of eigenvalues of U_N in a mesoscopic arc of the unit circle, regularized at an N-dependent scale Ɛ_N>0. We prove that the renormalized exponential of this field converges as N → ∞ to a Gaussian multiplicative chaos measure in the whole subcritical phase. In addition, we show that the moments of the total mass converge to a Selberg-like integral and by taking a further limit as the size of the arc diverges, we establish part of the conjectures in [55]. By an analogous construction, we prove that the multiplicative chaos measure coming from the sine process has the same distribution, which strongly suggests that this limiting object should be universal. The proofs are based on the asymptotic analysis of certain Toeplitz or Fredholm determinants using the Borodin-Okounkov formula or a Riemann-Hilbert problem for integrable operators. Our approach to the L¹-phase is based on a generalization of the construction in Berestycki [5] to random fields which are only asymptotically Gaussian. In particular, our method could have applications to other random fields coming from either random matrix theory or a different context

Investigation of island/single-core- And archipelago/multicore-enriched asphaltenes and their solubility fractions by thermal analysis coupled with high-resolution Fourier transform ion cyclotron resonance mass spectrometry.

Despite extensive research, the molecular-level chemical characterization of asphaltenes, a highly aromatic solubility fraction of petroleum, remains an analytical challenge. This fraction is related to diverse problems in crude oil exploration, transportation, and refining. Two asphaltene architecture motifs are commonly discussed in the literature, “island” (single-core)- and “archipelago” (multicore)-type structures. The thermal desorption and pyrolysis behavior of island- and archipelago-enriched asphaltenes and their extrography fractions was investigated. For this purpose, the evolved chemical pattern was investigated by thermal analysis coupled with ultrahigh-resolution mass spectrometry (Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS)). Soft atmospheric pressure chemical ionization preserved the molecular information of the thermal emission profile. Time-/temperature-resolved analysis allowed the chemical characterization of the occluded material as well as of asphaltene building blocks during pyrolysis. Regarding the thermogravimetric information, the island-type enriched sample (Wyoming asphaltenes) revealed a significantly higher coke residue after the pyrolysis process compared to the archipelago-type enriched sample (Athabasca asphaltenes). In contrast to whole asphaltenes, extrographic fractions revealed that occluded material evolved during the desorption phase. For the acetone fraction, this effect was the most abundant and suggests cooperative aggregation, which persists at high temperatures. Pyrolysis revealed a bimodal behavior for most of the compound classes, suggesting the presence of both architecture motifs in each asphaltene. double-bond equivalent (DBE) vs #C diagrams of the pyrolysis molecular profile revealed specific compositional trends: compounds with high DBE values and short alkylation are likely to be originated from island-type asphaltenes, whereas species with low DBE values and high carbon numbers likely derive from archipelago-type asphaltenes. In the asphaltene structural debate, thermal analysis ultrahigh-resolution mass spectrometry serves as an additional technique and supplements results obtained by other techniques, such as direct infusion approaches. Consistent results on the structural motifs are indicated by the molecular fingerprint visualized by DBE vs #C diagrams and serve as a measure for the dominance of a structural motif

Addressing thermal behavior and molecular architecture of asphaltenes by a thermal-optical carbon analyzer coupled to high-resolution mass spectrometry.

In the past decade, extensive molecular-level research on asphaltenes, primarily based on mass spectrometric approaches, acknowledged the coexistence of two primary architecture motifs, "island"single-core- and "archipelago"(multi-core)-type structures. Nonetheless, analytical methods for a classification are still limited. In this study, the thermal desorption and pyrolysis behavior of a diverse set of asphaltenes covering island- and archipelago-enriched samples and their extrographic fractions has been investigated by a thermal-optical carbon analyzer (TOCA) hyphenated to high-resolution mass spectrometric evolved gas analysis. The capability of the TOCA for a temperature-resolved quantification of the released carbon is used together with the option of applying an inert or oxidative atmosphere. We found that the relative proportion of organic carbon emitted under an inert atmosphere and below 580 °C (OCdes/pyr) and the organic carbon released at elevated temperatures (>580 °C) and oxidative atmosphere (OCpyrogen) can be used as a classification approach for the prevalent architecture motif. This finding is likely caused by differences in the coking and charring behavior dependent on molecular structure. Hypothetically, single-core constituents will form more resistive shot-like coke due to their larger aromatic cores, whereas multi-core constituents seem to produce easier combustible sponge-like coke. Simultaneously, resonance-enhanced multiphoton ionization (REMPI), a soft ionization scheme particularly selective and sensitive for aromatic constituents, together with Orbitrap Fourier-transform mass spectrometry, allowed for time/temperature-resolved in-depth insights into the evolved chemistry. The alkylation pattern/length of the mass spectra received in OCdes/pyr (480/580 °C) fractions has been identified as a classification measure with lower and more narrow patterns for the asphaltenes dominated by single-core species. However, grouping based on the quantified TOCA results has been significantly more striking. Conclusively, TOCA of asphaltenes and their extrographic fractions can be used for structural classification as well as insights into coprecipitated maltenes, presumably also successfully applicable in future studies on residues from renewable oil sources