Freezing of Gait Prediction From Accelerometer Data Using a Simple 1D-Convolutional Neural Network -- 8th Place Solution for Kaggle's Parkinson's Freezing of Gait Prediction Competition

Freezing of Gait (FOG) is a common motor symptom in patients with Parkinson's disease (PD). During episodes of FOG, patients suddenly lose their ability to stride as intended. Patient-worn accelerometers can capture information on the patient's movement during these episodes and machine learning algorithms can potentially classify this data. The combination therefore holds the potential to detect FOG in real-time. In this work I present a simple 1-D convolutional neural network that was trained to detect FOG events in accelerometer data. Model performance was assessed by measuring the success of the model to discriminate normal movement from FOG episodes and resulted in a mean average precision of 0.356 on the private leaderboard on Kaggle. Ultimately, the model ranked 8th out of 1379 teams in the Parkinson's Freezing of Gait Prediction competition. The results underscore the potential of Deep Learning-based solutions in advancing the field of FOG detection, contributing to improved interventions and management strategies for PD patients.Comment: 5 pages, 2 figures, competition report, for associated code see: https://github.com/janbrederecke/fo

Factor Analyses and Validity of the Transplant Evaluation Rating Scale (TERS) in a Large Sample of Lung Transplant Candidates

Objective: It is well known that the occurrence of mental disorders is more common in lung transplant candidates compared to the general population. After transplantation mental disorders may negatively affect quality of life, adherence to immunosuppressive medication, as well as overall survival. Therefore, the identification of patients at risk is of utmost importance and in Germany pre-transplant psychosocial evaluation of the patients is required. To ensure high quality and comparability of these assessments, the use of psychometrically sound instruments is recommended. We applied the Transplant Evaluation Rating Scale (TERS), a broadly used expert interview. Two research groups have detected a two-factor structure of the TERS in different transplant samples; however, with slightly different results. The present study investigated which of the models would fit best in our sample of lung transplant patients. Additionally, we assessed convergent and predictive validity of the best fitting model to evaluate its clinical usefulness. Methods: Between 2016 and 2019, 390 lung transplant candidates were evaluated and included in the study. The median age was 53 years and 54% were male. TERS interviews were conducted by trained medical doctors and psychologists. The participants completed questionnaires assessing quality of life and levels of depression and anxiety. Transplant- and disease-specific variables (lung disease, listing date, oxygen use) were taken from the patient charts. Confirmatory factor analysis was used to test the two proposed TERS-models in the present sample. Results: The two-factor structure of the TERS reported by Hoodin and Kalbfleisch fit our sample best, showing good psychometric properties. The factor “emotional sensitivity” was highly correlated with quality of life and measures of psychosocial health while the factor “defiance” correlated with obstructive lung disease and older age but not with quality of life. The two factors showed differential predictive validity with regard to time until listing and pulmonary-specific quality of life 1 year after transplantation. Conclusions: The two factors showed good psychometric properties, and differential convergent and predictive validity. However, further studies concentrating on the predictive value of the TERS and its factors regarding somatic outcomes (mortality, graft functioning) are required

Psychometric Properties of the German Version of the Pulmonary-Specific Quality-of-Life Scale in Lung Transplant Patients

The Pulmonary-Specific Quality-of-Life Scale (PQLS) is a validated self-report questionnaire assessing health-related quality of life (HRQoL) in patients with end-stage lung disease awaiting lung transplantation. The aim of our study was to evaluate the psychometric properties of the German version of the PQLS. One hundred and forty patients awaiting lung transplantation (55% men) with a median age of 53 years [Interquartile range (IQR) 13] answered the PQLS. A group of the participants (n = 43) was evaluated again 1 year later after transplantation. A confirmatory factor analysis (CFA) of the PQLS was conducted to test the three-factor structure of the PQLS. We examined the internal consistency of the scales using Cronbach’s α. Convergent validity was explored through correlations with generic measures of HRQoL [Short-Form 8 Health Survey (SF-8), 10-item quality of life (QoL) scale], measures of depression (nine-item Patient Health Questionnaire-Depression Scale), anxiety (Generalized Anxiety Scale), and measures of lung disease severity (supplemental oxygen use, stairway steps). In the group of 43 patients assessed before and after transplantation, sensitivity to change was explored. The CFA confirmed the three-factor model with an acceptable fit. The PQLS total and the three subscale scores “task interference,” “psychological,” and “physical” showed acceptable internal consistency. The PQLS and its subscales showed a significant negative correlation with the 10-item QoL measure and the physical component score of the SF-8, whereas the mental component score of the SF-8 showed a significant negative correlation only with the PQLS subscale “psychological.” Negative correlation was found due to the opposed alignment of the PQLS compared to the 10-item QoL and the SF-8. Symptoms of depression and anxiety were significantly and positively correlated with the subscale “psychological.” Measures of lung disease severity also exhibited a significant positive correlation with the subscales “task interference” and “physical” but not “psychological.” In patients 1 year after a successful transplantation, the PQLS scores were significantly reduced by 50%. The three-factor structure of the PQLS could be replicated using CFA. The results indicate good reliability, validity, and sensitivity to change of the German version of the PQLS

Psychometric properties of the German version of the Self Image Scale (SIS-D) in a sample of cancer patients.

BackgroundA cancer disease can affect the satisfaction with the physical appearance, so that the standardized assessment of the body image is important in cancer patients. The German version of the Self-Image Scale is a self-report measure that uses two subscales to assess appearance satisfaction (self-acceptance) and perceptions of partners' acceptance of their appearance (partner-acceptance). The present study aimed to validate the Self-Image Scale's two-factor structure in a sample of cancer patients with a variety of different diagnoses to further increase its utility.MethodsConfirmatory factor analysis methods were used to examine the two-factor model in a sample of cancer patients (N = 278). Scale reliability and validity were then assessed through internal consistency measures and correlations with external criteria such as depressiveness, anxiety, distress, and relationship satisfaction.ResultsThe proposed factor structure was supported by the results and the internal consistencies were good with α = .83 for the self-acceptance scale and α = .88 for the partner-acceptance scale while additional correlations with external criteria were observed as expected.ConclusionsThe results support the use of the German version of the Self-Image Scale in cancer patients in general. Future research directions include validation across further entities of cancer, the in-depth investigation of sex differences, and research in other diseases that might impact body image

Global Burden of Atrial Fibrillation and Flutter by National Income: Results From the Global Burden of Disease 2019 Database

Background Atrial fibrillation (AF) and atrial flutter (AFL) are common conditions that can lead to significant morbidity and death. We aimed to understand the distribution and disparities of the global burden of AF/AFL as well as the underlying risk factors. Methods and Results Data on the AF/AFL burden from the Global Burden of Disease data set were analyzed for the years 1990 to 2019, with countries grouped into low, lower‐middle, upper‐middle, and high national income classes according to World Bank categories. Data were supplemented with World Health Organization and World Bank information. The prevalence of AF/AFL has more than doubled (+120.7%) since 1990 in all income groups, though with a larger increment in middle‐income countries (+146.6% in lower‐middle‐ and +145.2% in upper‐middle‐income countries). In absolute numbers, 63.4% of AF/AFL cases originate from upper‐middle‐income countries, although the relative prevalence is highest in high‐income countries. Prevalence of AF/AFL appears to be correlated with medical doctor rate and life expectancy. The most relevant AF/AFL risk factors are unevenly distributed among income classes, with elevated blood pressure as the only risk factor that becomes less common with increasing income. The development of these risk factors differed over time. Conclusions The global burden of AF/AFL is increasing in all income groups and is more pronounced in middle‐income countries, with further growth to be expected. Underdiagnosis of AF/AFL in low‐ and middle‐income countries may contribute to lower reported prevalence. The risk factor distribution varies between income groups

Distress, anxiety, and depression in persons with hereditary cancer syndromes: Results from a nationwide cross‐sectional study in Germany

Abstract Background Persons with hereditary cancer syndromes (carriers) have a higher risk of developing cancer early. They are confronted with decisions regarding prophylactic surgeries, communication within their families, and childbearing. The present study aims to assess distress, anxiety, and depression in adult carriers and identify risk groups and predictors; clinicians can use to screen for particularly distressed persons. Methods N = 223 participants (n = 200 women, n = 23 men) with different hereditary cancer syndromes affected and unaffected by cancer answered questionnaires measuring their distress, anxiety, and depression levels. The sample was compared to the general population using one‐sample t‐tests. The n = 200 women with (n = 111) and without cancer (n = 89) were then compared and predictors for increased levels of anxiety and depression were identified using stepwise linear regression analyses. Results 66% reported clinical relevant distress, 47% reported clinical relevant anxiety, and 37% reported clinical relevant depression. Compared to the general population, carriers experienced increased distress, anxiety, and depression. Additionally, women with cancer suffered from more depressive symptoms than those without cancer. Past psychotherapy for a mental disorder and high distress were identified as predictors for increased anxiety and depression in female carriers. Conclusions The results suggest that the psychosocial consequences of hereditary cancer syndromes are serious. Clinicians could regularly screen carriers regarding anxiety and depression. The NCCN Distress Thermometer can be combined with questions about past psychotherapy to identify especially vulnerable persons. Further studies are needed to develop psychosocial interventions

Psychometric Properties of the German Version of the Pulmonary-Specific Quality-of-Life Scale in Lung Transplant Patients

The Pulmonary-Specific Quality-of-Life Scale (PQLS) is a validated self-report questionnaire assessing health-related quality of life (HRQoL) in patients with end-stage lung disease awaiting lung transplantation. The aim of our study was to evaluate the psychometric properties of the German version of the PQLS. One hundred and forty patients awaiting lung transplantation (55% men) with a median age of 53 years [Interquartile range (IQR) 13] answered the PQLS. A group of the participants (n = 43) was evaluated again 1 year later after transplantation. A confirmatory factor analysis (CFA) of the PQLS was conducted to test the three-factor structure of the PQLS. We examined the internal consistency of the scales using Cronbach's α. Convergent validity was explored through correlations with generic measures of HRQoL [Short-Form 8 Health Survey (SF-8), 10-item quality of life (QoL) scale], measures of depression (nine-item Patient Health Questionnaire-Depression Scale), anxiety (Generalized Anxiety Scale), and measures of lung disease severity (supplemental oxygen use, stairway steps). In the group of 43 patients assessed before and after transplantation, sensitivity to change was explored. The CFA confirmed the three-factor model with an acceptable fit. The PQLS total and the three subscale scores "task interference," "psychological," and "physical" showed acceptable internal consistency. The PQLS and its subscales showed a significant negative correlation with the 10-item QoL measure and the physical component score of the SF-8, whereas the mental component score of the SF-8 showed a significant negative correlation only with the PQLS subscale "psychological." Negative correlation was found due to the opposed alignment of the PQLS compared to the 10-item QoL and the SF-8. Symptoms of depression and anxiety were significantly and positively correlated with the subscale "psychological." Measures of lung disease severity also exhibited a significant positive correlation with the subscales "task interference" and "physical" but not "psychological." In patients 1 year after a successful transplantation, the PQLS scores were significantly reduced by 50%. The three-factor structure of the PQLS could be replicated using CFA. The results indicate good reliability, validity, and sensitivity to change of the German version of the PQLS.status: publishe

Psychometric properties of the German version of the Self-Image Scale (SIS-D).

Brederecke J, Scott JL, de Zwaan M, et al. Psychometric properties of the German version of the Self-Image Scale (SIS-D). PloS one. 2020;15(3): e0230331.BACKGROUND: The Self-Image Scale is a self-report measure originally developed for use in women with cancer. Two subscales assess appearance satisfaction (self-acceptance) and perceptions of partners' acceptance of their appearance (partner-acceptance). This study aimed to increase the Self-Image Scale's utility by 1) confirming the two-factor structure of the German version of the Self-Image Scale, 2) testing measurement invariance across sex and age groups and validity, and 3) gathering general population normative data.; METHODS: Confirmatory factor analysis methods were used to examine the proposed two-factor model in a random sample of adults from the general German population (N = 1367). Measurement invariance, scale reliability, and validity were assessed.; RESULTS: The original factor structure and measurement invariance across sexes and age groups were supported. Women showed significantly lower self-acceptance than men. Adolescent and young adult women showed higher self-acceptance than senior women. For both sexes, partner-acceptance lowered across successive age cohorts. Internal consistencies were good.; CONCLUSIONS: Results support the use of the German version of the Self-Image Scale in research and clinical practice. Research directions include validation in further diseases, collecting normative data across countries, and dyadic research, particularly exploring partner-acceptance across the life span

Exploring the incremental utility of circulating biomarkers for robust risk prediction of incident atrial fibrillation in European cohorts using regressions and modern machine learning methods

AIMS: To identify robust circulating predictors for incident atrial fibrillation (AF) using classical regressions and machine learning (ML) techniques within a broad spectrum of candidate variables. METHODS AND RESULTS: In pooled European community cohorts (n = 42 280 individuals), 14 routinely available biomarkers mirroring distinct pathophysiological pathways including lipids, inflammation, renal, and myocardium-specific markers (N-terminal pro B-type natriuretic peptide [NT-proBNP], high-sensitivity troponin I [hsTnI]) were examined in relation to incident AF using Cox regressions and distinct ML methods. Of 42 280 individuals (21 843 women [51.7%]; median [interquartile range, IQR] age, 52.2 [42.7, 62.0] years), 1496 (3.5%) developed AF during a median follow-up time of 5.7 years. In multivariable-adjusted Cox-regression analysis, NT-proBNP was the strongest circulating predictor of incident AF [hazard ratio (HR) per standard deviation (SD), 1.93 (95% CI, 1.82-2.04); P < 0.001]. Further, hsTnI [HR per SD, 1.18 (95% CI, 1.13-1.22); P < 0.001], cystatin C [HR per SD, 1.16 (95% CI, 1.10-1.23); P < 0.001], and C-reactive protein [HR per SD, 1.08 (95% CI, 1.02-1.14); P = 0.012] correlated positively with incident AF. Applying various ML techniques, a high inter-method consistency of selected candidate variables was observed. NT-proBNP was identified as the blood-based marker with the highest predictive value for incident AF. Relevant clinical predictors were age, the use of antihypertensive medication, and body mass index. CONCLUSION: Using different variable selection procedures including ML methods, NT-proBNP consistently remained the strongest blood-based predictor of incident AF and ranked before classical cardiovascular risk factors. The clinical benefit of these findings for identifying at-risk individuals for targeted AF screening needs to be elucidated and tested prospectively