Influence of clinical and gait analysis experience on reliability of observational gait analysis (Edinburgh Gait Score Reliability)

AbstractObjectivesTreatment complexity of cerebral palsy (CP) patients imposes outcome evaluation studies, which may include objective technical analysis and more subjective functional evaluation. The Edinburgh Gait Score (EGS) was proposed as an additive or alternative when complex instrumented three-dimensional gait analysis is not available. Our purposes were to apply a translated EGS to standard video recordings of independent walking spastic diplegic CP patients, to evaluate its intraobserver and interobserver reliability with respect to gait analysis familiar and not familiar observers.MethodsTen standard video recordings acquired during routine clinical gait analysis were examined by eight observers gait analysis interpretation experienced or not, out of various specialities, two times with a two weeks interval. Kappa statistics and intraclass correlation coefficient were calculated.ResultsBetter reliability was observed for foot and knee scores than in proximal segments with significant differences between stance and swing phase. Significantly better results in gait analysis trained observers underlines the importance to either be used to clinical gait analysis interpretation, or to benefit of video analysis training before observational scoring.ConclusionVisual evaluation may be used for outcome studies to explore clinical changes in CP patients over time and may be associated to other validated evaluation tools

Design, realization and measurements of a miniature antenna for implantable wireless communication systems

The design procedure, realization and measurements of an implantable radiator for telemetry applications are presented. First, free space analysis allows the choice of the antenna typology with reduced computation time. Subsequently the antenna, inserted in a body phantom, is designed to take into account all the necessary electronic components, power supply and bio-compatible insulation so as to realize a complete implantable device. The conformal design has suitable dimensions for subcutaneous implantation (10 x 32.1 mm). The effect of different body phantoms is discussed. The radiator works in both the Medical Device Radiocommunication Service (MedRadio, 401-406 MHz) and the Industrial, Scientific and Medical (ISM, 2.4-2.5 GHz) bands. Simulated maximum gains attain and -28.8 and -18.5 dBi in the two desired frequency ranges, respectively, when the radiator is implanted subcutaneously in a homogenous cylindrical body phantom (80 x 110 mm) with muscle equivalent dielectric properties. Three antennas are realized and characterized in order to improve simulation calibration, electromagnetic performance, and to validate the repeatability of the manufacturing process. Measurements are also presented and a good correspondence with theoretical predictions is registered

Instantaneous Normal Mode Analysis of Supercooled Water

We use the instantaneous normal mode approach to provide a description of the local curvature of the potential energy surface of a model for water. We focus on the region of the phase diagram in which the dynamics may be described by the mode-coupling theory. We find, surprisingly, that the diffusion constant depends mainly on the fraction of directions in configuration space connecting different local minima, supporting the conjecture that the dynamics are controlled by the geometric properties of configuration space. Furthermore, we find an unexpected relation between the number of basins accessed in equilibrium and the connectivity between them.Comment: 5 pages, 4 figure

Bumetanide for autism: more eye contact, less amygdala activation.

We recently showed that constraining eye contact leads to exaggerated increase of amygdala activation in autism. Here, in a proof of concept pilot study, we demonstrate that administration of bumetanide (a NKCC1 chloride importer antagonist that restores GABAergic inhibition) normalizes the level of amygdala activation during constrained eye contact with dynamic emotional face stimuli in autism. In addition, eye-tracking data reveal that bumetanide administration increases the time spent in spontaneous eye gaze during in a free-viewing mode of the same face stimuli. In keeping with clinical trials, our data support the Excitatory/Inhibitory dysfunction hypothesis in autism, and indicate that bumetanide may improve specific aspects of social processing in autism. Future double-blind placebo controlled studies with larger cohorts of participants will help clarify the mechanisms of bumetanide action in autism

Present state of global wetland extent and wetland methane modelling: methodology of a model inter-comparison project (WETCHIMP)

The Wetland and Wetland CH4 Intercomparison of Models Project (WETCHIMP) was created to evaluate our present ability to simulate large-scale wetland characteristics and corresponding methane (CH4) emissions. A multi-model comparison is essential to evaluate the key uncertainties in the mechanisms and parameters leading to methane emissions. Ten modelling groups joined WETCHIMP to run eight global and two regional models with a common experimental protocol using the same climate and atmospheric carbon dioxide (CO2) forcing datasets. We reported the main conclusions from the intercomparison effort in a companion paper (Melton et al., 2013). Here we provide technical details for the six experiments, which included an equilibrium, a transient, and an optimized run plus three sensitivity experiments (temperature, precipitation, and atmospheric CO2 concentration). The diversity of approaches used by the models is summarized through a series of conceptual figures, and is used to evaluate the wide range of wetland extent and CH4 fluxes predicted by the models in the equilibrium run. We discuss relationships among the various approaches and patterns in consistencies of these model predictions. Within this group of models, there are three broad classes of methods used to estimate wetland extent: prescribed based on wetland distribution maps, prognostic relationships between hydrological states based on satellite observations, and explicit hydrological mass balances. A larger variety of approaches was used to estimate the net CH4 fluxes from wetland systems. Even though modelling of wetland extent and CH4 emissions has progressed significantly over recent decades, large uncertainties still exist when estimating CH4 emissions: there is little consensus on model structure or complexity due to knowledge gaps, different aims of the models, and the range of temporal and spatial resolutions of the models

Present state of global wetland extent and wetland methane modelling: conclusions from a model inter-comparison project (WETCHIMP)

Global wetlands are believed to be climate sensitive, and are the largest natural emitters of methane (CH4). Increased wetland CH4 emissions could act as a positive feedback to future warming. The Wetland and Wetland CH4 Inter-comparison of Models Project (WETCHIMP) investigated our present ability to simulate large-scale wetland characteristics and corresponding CH4 emissions. To ensure inter-comparability, we used a common experimental protocol driving all models with the same climate and carbon dioxide (CO2) forcing datasets. The WETCHIMP experiments were conducted for model equilibrium states as well as transient simulations covering the last century. Sensitivity experiments investigated model response to changes in selected forcing inputs (precipitation, temperature, and atmospheric CO2 concentration). Ten models participated, covering the spectrum from simple to relatively complex, including models tailored either for regional or global simulations. The models also varied in methods to calculate wetland size and location, with some models simulating wetland area prognostically, while other models relied on remotely sensed inundation datasets, or an approach intermediate between the two. Four major conclusions emerged from the project. First, the suite of models demonstrate extensive disagreement in their simulations of wetland areal extent and CH4 emissions, in both space and time. Simple metrics of wetland area, such as the latitudinal gradient, show large variability, principally between models that use inundation dataset information and those that independently determine wetland area. Agreement between the models improves for zonally summed CH4 emissions, but large variation between the models remains. For annual global CH4 emissions, the models vary by ±40% of the all-model mean (190 Tg CH4 yr−1). Second, all models show a strong positive response to increased atmospheric CO2 concentrations (857 ppm) in both CH4 emissions and wetland area. In response to increasing global temperatures (+3.4 °C globally spatially uniform), on average, the models decreased wetland area and CH4 fluxes, primarily in the tropics, but the magnitude and sign of the response varied greatly. Models were least sensitive to increased global precipitation (+3.9 % globally spatially uniform) with a consistent small positive response in CH4 fluxes and wetland area. Results from the 20th century transient simulation show that interactions between climate forcings could have strong non-linear effects. Third, we presently do not have sufficient wetland methane observation datasets adequate to evaluate model fluxes at a spatial scale comparable to model grid cells (commonly 0.5°). This limitation severely restricts our ability to model global wetland CH4 emissions with confidence. Our simulated wetland extents are also difficult to evaluate due to extensive disagreements between wetland mapping and remotely sensed inundation datasets. Fourth, the large range in predicted CH4 emission rates leads to the conclusion that there is both substantial parameter and structural uncertainty in large-scale CH4 emission models, even after uncertainties in wetland areas are accounted for

Observation of B0->pi0pi0

We report the first observation of the decay B0->pi0pi0, using a 253/fb data sample collected at the Upsilon(4S) resonance with the Belle detector at the KEKB e+e- collider. The measured branching fraction is BF(B0->pi0pi0) = {2.32 +0.4-0.5(stat) +0.2-0.3(syst)} x 10^-6, with a significance of 5.8 standard deviations including systematic uncertainties. We also make the first measurement of the direct CP violating asymmetry in this mode.Comment: 6 pages, 2 figures, submitted to ICHEP04, Beijing and Physical Review Letters. v2: a possible pile-up background is checked and a systematic error for it is include

Measurement of branching fraction ratios and CP asymmetries in B±→DCPK±B^{\pm} \to D_{CP}K^{\pm}

We report results on the decay $B^{-} \to D_{CP}K^{-}$ and its charge conjugate using a data sample of 85.4 million $B\bar{B}$ pairs recorded at the $\Upsilon(4S)$ resonance with the Belle detector at the KEKB asymmetric $e^{+}e^{-}$ storage ring. Ratios of branching fractions of Cabibbo-suppressed to Cabibbo-favored processes are determined to be ${\cal B}(B^- \to D^0 K^-)/{\cal B}(B^- \to D^0 \pi^-)= 0.077 \pm 0.005(stat) \pm 0.006(sys)$, ${\cal B}(B^- \to D_1 K^-)/{\cal B}(B^- \to D_1 \pi^-) = 0.093 \pm 0.018(stat) \pm 0.008(sys)$ and ${\cal B}(B^- \to D_2 K^-)/{\cal B}(B^- \to D_2 \pi^-) = 0.108 \pm 0.019(stat) \pm 0.007(sys)$ where the indices 1 and 2 represent the CP=+1 and CP=$-$1 eigenstates of the $D^{0}-\bar{D^{0}}$ system, respectively. We find the partial-rate charge asymmetries for $B^{-} \to D_{CP}K^{-}$ to be ${\cal{A}}_1 = 0.06 \pm 0.19(stat) \pm 0.04(sys)$ and ${\cal{A}}_2 = -0.19 \pm 0.17(stat) \pm 0.05(sys)$.Comment: 10 pages, 3 figures, submitted to Physical Review

Measurement of phi_3 with Dalitz plot analysis of B+ -> D(*)K(*)+ decay

We present a measurement of the unitarity triangle angle phi_3 using a Dalitz plot analysis of the K0_S pi+ pi- decay of the neutral D meson from the B+- -> D(*)K(*)+- process. The method employs the interference between D0 and D0bar to extract the angle phi_3, strong phase Delta and the ratio r of suppressed and allowed amplitudes. We apply this method to a 357 fb-1 data sample collected by the Belle experiment. The analysis uses three modes: B+ -> DK+, B+ -> D*K+ with D* -> Dpi0, and B+ -> DK*+ with K*+ -> K0_S pi+, as well as the corresponding charge-conjugate modes. From a combined maximum likelihood fit to the three modes, we obtain phi_3=53+15-18(stat)+-3(syst)+-9(model) degrees. The corresponding two standard deviation interval is 8<phi_3<111 degrees.Comment: 18 pages, 6 figures, 7 tables. To be submitted to Phys. Rev.