Modern psychometrics applied in rheumatology - a systematic review

Background Although item response theory (IRT) appears to be increasingly used within health care research in general, a comprehensive overview of the frequency and characteristics of IRT analyses within the rheumatic field is lacking. An overview of the use and application of IRT in rheumatology to date may give insight into future research directions and highlight new possibilities for the improvement of outcome assessment in rheumatic conditions. Therefore, this study systematically reviewed the application of IRT to patient-reported and clinical outcome measures in rheumatology. Methods Literature searches in PubMed, Scopus and Web of Science resulted in 99 original English-language articles which used some form of IRT-based analysis of patient-reported or clinical outcome data in patients with a rheumatic condition. Both general study information and IRT-specific information were assessed. Results Most studies used Rasch modeling for developing or evaluating new or existing patient-reported outcomes in rheumatoid arthritis or osteoarthritis patients. Outcomes of principle interest were physical functioning and quality of life. Since the last decade, IRT has also been applied to clinical measures more frequently. IRT was mostly used for evaluating model fit, unidimensionality and differential item functioning, the distribution of items and persons along the underlying scale, and reliability. Less frequently used IRT applications were the evaluation of local independence, the threshold ordering of items, and the measurement precision along the scale. Conclusion IRT applications have markedly increased within rheumatology over the past decades. To date, IRT has primarily been applied to patient-reported outcomes, however, applications to clinical measures are gaining interest. Useful IRT applications not yet widely used within rheumatology include the cross-calibration of instrument scores and the development of computerized adaptive tests which may reduce the measurement burden for both the patient and the clinician. Also, the measurement precision of outcome measures along the scale was only evaluated occasionally. Performed IRT analyses should be adequately explained, justified, and reported. A global consensus about uniform guidelines should be reached concerning the minimum number of assumptions which should be met and best ways of testing these assumptions, in order to stimulate the quality appraisal of performed IRT analyses

Intra-residue methyl-methyl correlations for valine and leucine residues in large proteins from a 3D-HMBC-HMQC experiment

Methyl-TROSY based NMR experiments have over the last two decades become one of the most important means to characterise dynamics and functional mechanisms of large proteins and macromolecular machines in solution. The chemical shift assignment of methyl groups in large proteins is, however, still not trivial and it is typically performed using backbone-dependent experiments in a ‘divide and conquer’ approach, mutations, structure-based assignments or a combination of these. Structure-based assignment of methyl groups is an emerging strategy, which reduces the time and cost required as well as providing a method that is independent of a backbone assignment. One crucial step in available structure-based assignment protocols is linking the two prochiral methyl groups of leucine and valine residues. This has previously been achieved by recording NOESY spectra with short mixing times or by comparing NOESY spectra. Herein, we present a method based on through-bond scalar coupling transfers, a 3D-HMBC-HMQC experiment, to link the intra-residue methyl groups of leucine and valine. It is shown that the HMBC-HMQC method has several advantages over solely using NOESY spectra since a unique intra-residue cross-peak is observed. Moreover, overlap in the methyl-TROSY HMQC spectrum can easily be identified with the HMBC-HMQC experiment, thereby removing possible ambiguities in the assignment

Aromatic side-chain flips orchestrate the conformational sampling of functional loops in human histone deacetylase 8

Human histone deacetylase 8 (HDAC8) is a key hydrolase in gene regulation and an important drug-target. High-resolution structures of HDAC8 in complex with substrates or inhibitors are available, which have provided insights into the bound state of HDAC8 and its function. Here, using long all-atom unbiased molecular dynamics simulations and Markov state modelling, we show a strong correlation between the conformation of aromatic side chains near the active site and opening and closing of the surrounding functional loops of HDAC8. We also investigated two mutants known to allosterically downregulate the enzymatic activity of HDAC8. Based on experimental data, we hypothesise that I19S-HDAC8 is unable to release the product, whereas both product release and substrate binding are impaired in the S39E-HDAC8 mutant. The presented results deliver detailed insights into the functional dynamics of HDAC8 and provide a mechanism for the substantial downregulation caused by allosteric mutations, including a disease causing one

Reflection confocal nanoscopy using a super-oscillatory lens

A Superoscillatory lens (SOL) is known to produce a sub-diffraction hotspot which is useful for high-resolution imaging. However, high-energy rings called sidelobes coexist with the central hotspot. Additionally, SOLs have not yet been directly used to image reflective objects due to low efficiency and poor imaging properties. We propose a novel reflection confocal nanoscope which mitigates these issues by relaying the SOL intensity pattern onto the object and use conventional optics for detection. We experimentally demonstrate super-resolution by imaging double bars with 330 nm separation using a 632.8 nm excitation and a 0.95 NA objective. We also discuss the enhanced contrast properties of the SOL nanoscope against a laser confocal microscope, and the degradation of performance while imaging large objects.Comment: 17 pages, 15 figures, supplementary include

Determination of the spin-flip time in ferromagnetic SrRuO3 from time-resolved Kerr measurements

We report time-resolved Kerr effect measurements of magnetization dynamics in ferromagnetic SrRuO3. We observe that the demagnetization time slows substantially at temperatures within 15K of the Curie temperature, which is ~ 150K. We analyze the data with a phenomenological model that relates the demagnetization time to the spin flip time. In agreement with our observations the model yields a demagnetization time that is inversely proportional to T-Tc. We also make a direct comparison of the spin flip rate and the Gilbert damping coefficient showing that their ratio very close to kBTc, indicating a common origin for these phenomena

Understanding the nature of electronic effective mass in double-doped SrTiO3_{3}

We present an approach to tune the effective mass in an oxide semiconductor by a double doping mechanism. We demonstrate this in a model oxide system Sr$_{1-x}$La$_x$TiO$_{3-\delta}$, where we can tune the effective mass ranging from 6--20$\mathrm{m_e}$ as a function of filling or carrier concentration and the scattering mechanism, which are dependent on the chosen lanthanum and oxygen vacancy concentrations. The effective mass values were calculated from the Boltzmann transport equation using the measured transport properties of thin films of Sr$_{1-x}$La$_x$TiO$_{3-\delta}$. Our method, which shows that the effective mass decreases with carrier concentration, provides a means for understanding the nature of transport processes in oxides, which typically have large effective mass and low electron mobility, contrary to the tradional high mobility semiconductors.Comment: 5 pages with 4 figure

Macrocephaly in an 8-month-old infant

An 8-month-old infant presents with macrocephaly and a mild motoric deficit. The pediatrician asks a complementary MR examination to exclude hydrocephalus

How age and sex affect the erythrocyte sedimentation rate and C-reactive protein in early rheumatoid arthritis

BACKGROUND: The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are two commonly used measures of inflammation in rheumatoid arthritis (RA). As current RA treatment guidelines strongly emphasize early and aggressive treatment aiming at fast remission, optimal measurement of inflammation becomes increasingly important. Dependencies with age, sex, and body mass index have been shown for both inflammatory markers, yet it remains unclear which inflammatory marker is affected least by these effects in patients with early RA. METHODS: Baseline data from 589 patients from the DREAM registry were used for analyses. Associations between the inflammatory markers and age, sex, and BMI were evaluated first using univariate linear regression analyses. Next, it was tested whether these associations were independent of a patient's current disease activity as well as of each other using multiple linear regression analyses with backward elimination. The strengths of the associations were compared using standardized beta (beta) coefficients. The multivariate analyses were repeated after 1 year. RESULTS: At baseline, both the ESR and CRP were univariately associated with age, sex, and BMI, although the association with BMI disappeared in multivariate analyses. ESR and CRP levels significantly increased with age (beta-ESR = 0.017, p < 0.001 and beta-CRP = 0.009, p = 0.006), independent of the number of tender and swollen joints, general health, and sex. For each decade of aging, ESR and CRP levels became 1.19 and 1.09 times higher, respectively. Furthermore, women demonstrated average ESR levels that were 1.22 times higher than that of men (beta = 0.198, p = 0.007), whereas men had 1.20 times higher CRP levels (beta = -0.182, p = 0.048). Effects were strongest on the ESR. BMI became significantly associated with both inflammatory markers after 1 year, showing higher levels with increasing weight. Age continued to be significantly associated, whereas sex remained only associated with the ESR level. CONCLUSIONS: Age and sex are independently associated with the levels of both acute phase reactants in early RA, emphasizing the need to take these external factors into account when interpreting disease activity measures. BMI appears to become more relevant at later stages of the disease