Assessing plantar sensation in the foot using the FOot Roughness Discrimination Test (FoRDT™): a reliability and validity study in stroke

BACKGROUND: The foot sole represents a sensory dynamometric map and is essential for balance and gait control. Sensory impairments are common, yet often difficult to quantify in neurological conditions, particularly stroke. A functionally oriented and quantifiable assessment, the Foot Roughness Discrimination Test (FoRDT™), was developed to address these shortcomings. OBJECTIVE: To evaluate inter- and intra-rater reliability, convergent and discriminant validity of the Foot Roughness Discrimination Test (FoRDT™). DESIGN: Test-retest design. SETTING: Hospital Outpatient. PARTICIPANTS: Thirty-two people with stroke (mean age 70) at least 3 months after stroke, and 32 healthy, age-matched controls (mean age 70). MAIN OUTCOME MEASURES: Roughness discrimination thresholds were quantified utilising acrylic foot plates, laser-cut to produce graded spatial gratings. Stroke participants were tested on three occasions, and by two different raters. Inter- and intra-rater reliability and agreement were evaluated with Intraclass Correlation Coefficients and Bland-Altman plots. Convergent validity was evaluated through Spearman rank correlation coefficients (rho) between the FoRDT™ and the Erasmus modified Nottingham Sensory Assessment (EmNSA). RESULTS: Intra- and inter rater reliability and agreement were excellent (ICC =.86 (95% CI .72-.92) and .90 (95% CI .76 -.96)). Discriminant validity was demonstrated through significant differences in FoRDT™ between stroke and control participants (p.05). CONCLUSIONS: This simple and functionally oriented test of plantar sensation is reliable, valid and clinically feasible for use in an ambulatory, chronic stroke and elderly population. It offers clinicians and researchers a sensitive and robust sensory measure and may further support the evaluation of rehabilitation targeting foot sensation. This article is protected by copyright. All rights reserved

Vocabulary Learning in a Yorkshire Terrier: Slow Mapping of Spoken Words

Rapid vocabulary learning in children has been attributed to “fast mapping”, with new words often claimed to be learned through a single presentation. As reported in 2004 in Science a border collie (Rico) not only learned to identify more than 200 words, but fast mapped the new words, remembering meanings after just one presentation. Our research tests the fast mapping interpretation of the Science paper based on Rico's results, while extending the demonstration of large vocabulary recognition to a lap dog. We tested a Yorkshire terrier (Bailey) with the same procedures as Rico, illustrating that Bailey accurately retrieved randomly selected toys from a set of 117 on voice command of the owner. Second we tested her retrieval based on two additional voices, one male, one female, with different accents that had never been involved in her training, again showing she was capable of recognition by voice command. Third, we did both exclusion-based training of new items (toys she had never seen before with names she had never heard before) embedded in a set of known items, with subsequent retention tests designed as in the Rico experiment. After Bailey succeeded on exclusion and retention tests, a crucial evaluation of true mapping tested items previously successfully retrieved in exclusion and retention, but now pitted against each other in a two-choice task. Bailey failed on the true mapping task repeatedly, illustrating that the claim of fast mapping in Rico had not been proven, because no true mapping task had ever been conducted with him. It appears that the task called retention in the Rico study only demonstrated success in retrieval by a process of extended exclusion

Photo-reverberation mapping of a protoplanetary accretion disk around a T Tauri star

This is the final version. Available from the American Astronomical Society via the DOI in this recordTheoretical models and spectroscopic observations of newborn stars suggest that protoplantary disks have an inner "wall" at a distance set by the disk interaction with the star. Around T Tauri stars, the size of this disk hole is expected to be on a 0.1 au scale that is unresolved by current adaptive optics imaging, though some model-dependent constraints have been obtained by near-infrared interferometry. Here we report the first measurement of the inner disk wall around a solar-mass young stellar object, YLW 16B in the ρ Ophiuchi star-forming region, by detecting the light-travel time of the variable radiation from the stellar surface to the disk. Consistent time lags were detected on two nights, when the time series in H (1.6 μm) and K (2.2 μm) bands were synchronized while the 4.5 μm emission lagged by 74.5 ± 3.2 s. Considering the nearly edge-on geometry of the disk, the inner rim should be 0.084 au from the protostar on average, with an error of order 0.01 au. This size is likely larger than the range of magnetospheric truncations and consistent with an optically and geometrically thick disk front at the dust sublimation radius at ∼1500 K. The widths of the cross-correlation functions between the data in different wavebands place possible new constraints on the geometry of the disk.National Science Foundation (NSF

An Age-Structured Extension to the Vectorial Capacity Model

Vectorial capacity and the basic reproductive number (R(0)) have been instrumental in structuring thinking about vector-borne pathogen transmission and how best to prevent the diseases they cause. One of the more important simplifying assumptions of these models is age-independent vector mortality. A growing body of evidence indicates that insect vectors exhibit age-dependent mortality, which can have strong and varied affects on pathogen transmission dynamics and strategies for disease prevention.Based on survival analysis we derived new equations for vectorial capacity and R(0) that are valid for any pattern of age-dependent (or age-independent) vector mortality and explore the behavior of the models across various mortality patterns. The framework we present (1) lays the groundwork for an extension and refinement of the vectorial capacity paradigm by introducing an age-structured extension to the model, (2) encourages further research on the actuarial dynamics of vectors in particular and the relationship of vector mortality to pathogen transmission in general, and (3) provides a detailed quantitative basis for understanding the relative impact of reductions in vector longevity compared to other vector-borne disease prevention strategies.Accounting for age-dependent vector mortality in estimates of vectorial capacity and R(0) was most important when (1) vector densities are relatively low and the pattern of mortality can determine whether pathogen transmission will persist; i.e., determines whether R(0) is above or below 1, (2) vector population growth rate is relatively low and there are complex interactions between birth and death that differ fundamentally from birth-death relationships with age-independent mortality, and (3) the vector exhibits complex patterns of age-dependent mortality and R(0) ∼ 1. A limiting factor in the construction and evaluation of new age-dependent mortality models is the paucity of data characterizing vector mortality patterns, particularly for free ranging vectors in the field

Wolbachia Induces Male-Specific Mortality in the Mosquito Culex pipiens (LIN Strain)

Background: Wolbachia are maternally inherited endosymbionts that infect a diverse range of invertebrates, including insects, arachnids, crustaceans and filarial nematodes. Wolbachia are responsible for causing diverse reproductive alterations in their invertebrate hosts that maximize their transmission to the next generation. Evolutionary theory suggests that due to maternal inheritance, Wolbachia should evolve toward mutualism in infected females, but strict maternal inheritance means there is no corresponding force to select for Wolbachia strains that are mutualistic in males. Methodology/Principal findings: Using cohort life-table analysis, we demonstrate that in the mosquito Culex pipiens (LIN strain), Wolbachia-infected females show no fitness costs due to infection. However, Wolbachia induces up to a 30% reduction in male lifespan. Conclusions/significance: These results indicate that the Wolbachia infection of the Culex pipiens LIN strain is virulent in a sex-specific manner. Under laboratory situations where mosquitoes generally mate at young ages, Wolbachia strains that reduce male survival could evolve by drift because increased mortality in older males is not a significant selective force

Prediction of Obesity in Children at 5 years: A Cohort Study

Objective To examine determinants of moderate and severe obesity in children at 5 years of age. Methodology A prospective cohort of mothers were enrolled at first antenatal visit, and interviewed shortly after delivery, at 6 months and 5 years. Detailed health, psychological and social questionnaires were completed at each phase by mothers, and child health questionnaires at 6 months and 5 years. At 5 years 4062 children were assessed physically, the Peabody Picture Vocabulary Test administered and mothers completed a modified Child Behaviour Checklist. Moderate obesity was defined as BMI between 85th and 94th percentiles inclusively, and severe obesity as a BMI greater than the 94th percentile. Results Independent predictors of severe obesity at 5 years were birthweight, female gender, maternal BMI and paternal BMI. Moderate obesity at 5 years was predicted by birthweight, paternal BMI and sleeplessness at 6 months, while small for gestational age (SGA) status and feeding problems at 6 months were protective factors for moderate obesity. Obesity was not associated with problems of language comprehension or behaviour. Conclusions Findings of this study suggest that biological rather than psychosocial factors are the major determinants of obesity at 5 years

Skin-derived fibroblasts from long-lived species are resistant to some, but not all, lethal stresses and to the mitochondrial inhibitor rotenone

Fibroblast cell lines were developed from skin biopsies of eight species of wild-trapped rodents, one species of bat, and a group of genetically heterogeneous laboratory mice. Each cell line was tested in vitro for their resistance to six varieties of lethal stress, as well as for resistance to the nonlethal metabolic effects of the mitochondrial inhibitor rotenone and of culture at very low glucose levels. Standard linear regression of species-specific lifespan against each species mean stress resistance showed that longevity was associated with resistance to death induced by cadmium and hydrogen peroxide, as well as with resistance to rotenone inhibition. A multilevel regression method supported these associations, and suggested a similar association for resistance to heat stress. Regressions for resistance to cadmium, peroxide, heat, and rotenone remained significant after various statistical adjustments for body weight. In contrast, cells from longer-lived species did not show significantly greater resistance to ultraviolet light, paraquat, or the DNA alkylating agent methylmethanesulfonate. There was a strong correlation between species longevity and resistance to the metabolic effects of low-glucose medium among the rodent cell lines, but this test did not distinguish mice and rats from the much longer-lived little brown bat. These results are consistent with the idea that evolution of long-lived species may require development of cellular resistance to several forms of lethal injury, and provide justification for evaluation of similar properties in a much wider range of mammals and bird species.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73523/1/j.1474-9726.2006.00255.x.pd

The clinical features of the piriformis syndrome: a systematic review

Piriformis syndrome, sciatica caused by compression of the sciatic nerve by the piriformis muscle, has been described for over 70 years; yet, it remains controversial. The literature consists mainly of case series and narrative reviews. The objectives of the study were: first, to make the best use of existing evidence to estimate the frequencies of clinical features in patients reported to have PS; second, to identify future research questions. A systematic review was conducted of any study type that reported extractable data relevant to diagnosis. The search included all studies up to 1 March 2008 in four databases: AMED, CINAHL, Embase and Medline. Screening, data extraction and analysis were all performed independently by two reviewers. A total of 55 studies were included: 51 individual and 3 aggregated data studies, and 1 combined study. The most common features found were: buttock pain, external tenderness over the greater sciatic notch, aggravation of the pain through sitting and augmentation of the pain with manoeuvres that increase piriformis muscle tension. Future research could start with comparing the frequencies of these features in sciatica patients with and without disc herniation or spinal stenosis

The predictive and prognostic value of tumour necrosis in muscle invasive bladder cancer patients receiving radiotherapy with or without chemotherapy in the BC2001 trial (CRUK/01/004)

Background: Severe chronic hypoxia is associated with tumour necrosis. In patients with muscle invasive bladder cancer (MIBC), necrosis is prognostic for survival following surgery or radiotherapy and predicts benefit from hypoxia modification of radiotherapy. Adding mitomycin C (MMC) and 5-fluorouracil (5-FU) chemotherapy to radiotherapy improved locoregional control (LRC) compared to radiotherapy alone in the BC2001 trial. We hypothesised that tumour necrosis would not predict benefit for the addition of MMC and 5-FU to radiotherapy, but would be prognostic. Methods: Diagnostic tumour samples were available from 230 BC2001 patients. Tumour necrosis was scored on whole-tissue sections as absent or present, and its predictive and prognostic significance explored using Cox proportional hazards models. Survival estimates were obtained by Kaplan–Meier methods. Results: Tumour necrosis was present in 88/230 (38%) samples. Two-year LRC estimates were 71% (95% CI 61–79%) for the MMC/5-FU chemoradiotherapy group and 49% (95% CI 38–59%) for the radiotherapy alone group. When analysed by tumour necrosis status, the adjusted hazard ratios (HR) for MMC/5-FU vs. no chemotherapy were 0.46 (95% CI: 0.12–0.99; P=0.05, necrosis present) and 0.55 (95% CI: 0.31–0.98; P=0.04, necrosis absent). Multivariable analysis of prognosis for LRC by the presence vs. absence of necrosis yielded a HR=0.89 (95% CI 0.55–1.44, P=0.65). There was no significant association for necrosis as a predictive or prognostic factor with respect to overall survival. Conclusions: Tumour necrosis was neither predictive nor prognostic, and therefore MMC/5-FU is an appropriate radiotherapy-sensitising treatment in MIBC independent of necrosis status

Lifestyle index for mortality prediction using multiple ageing cohorts in the USA, UK and Europe

Current mortality prediction indexes are mainly based on functional morbidity and comorbidity, with limited information for risk prevention. This study aimed to develop and validate a modifiable lifestyle-based mortality predication index for older adults. Data from 51,688 participants (56% women) aged ≥50 years in 2002 Health and Retirement Study, 2002 English Longitudinal Study of Ageing and 2004 Survey of Health Ageing and Retirement in Europe were used to estimate coefficients of the index with cohort-stratified Cox regression. Models were validated across studies and compared to the Lee index (having comorbid and morbidity predictors). Over an average of 11-year follow-up, 10,240 participants died. The lifestyle index includes smoking, drinking, exercising, sleep quality, BMI, sex and age; showing adequate model performance in internal validation (C-statistic 0.79; D-statistic 1.94; calibration slope 1.13) and in all combinations of internal-external cross-validation. It outperformed Lee index (e.g. differences in C-statistic = 0.01, D-statistic = 0.17, P < 0.001) consistently across health status. The lifestyle index stratified participants into varying mortality risk groups, with those in the top quintile having 13.5% excess absolute mortality risk over 10 years than those in the bottom 50th centile. Our lifestyle index with easy-assessable behavioural factors and improved generalizability may maximize its usability for personalized risk management