Nasolabial Fold Dynamics: Implications for Facial Paralysis and Facial Reanimation Surgery

ObjectivesIn patients with facial paralysis, facial reanimation surgery may be needed to normalize facial soft tissue function/movements. Critical for this normalization is the dynamics of the nasolabial folds (NLFs). The objective of this prospective, observational study was to determine the 3D morphologic dynamics of the NLFs in patients with unilateral facial palsy and normal subjects.Settings and Sample Population3D facial soft tissue movement data collected from adults with unilateral, facial paralysis (Bell's Palsy, n=36); and (2) an age‐ and sex‐frequency matched control group (n=68).Materials and MethodsMovement data were collected during repeated animations from participants using a video‐based motion capture system. Movement in terms of displacement and asymmetry of the NLFs, nasal, and circumoral regions were analyzed in the lateral, vertical and depth planes; as well as movement of the commissure and NLFs relative to the lower lip midline. Two sample t tests were used to test for significant group differences.ResultsPatients NLFs had less mean displacement, greater mean asymmetry, and uncoordinated movements compared with the controls. For both groups during smiling, the NLF and commissure landmarks had approximately similar magnitudes of displacement (control range = 11‐14mm; patient range = 7‐10mm).ConclusionNLF dynamics during smiling were as significant as oral commissure excursion. Thus, an immobile NLF is an unnatural feature of facial animations. Surgical treatments that address impaired NFL movements must be considered to create a more natural surgical outcome especially during smiling.<br/

Response Conversion for Improving Comparability of International Physical Activity Data

Background: Many questionnaires for measuring physical activity (PA) exist. This complicates the comparison of outcomes. Methods: In 8 European countries, PA was measured in random samples of 600 persons, using the IPAQ as a 'bridge' to historical sets of country-specific questions. We assume that a unidimensional scale of PA ability exists on which items and respondents can be placed, irrespective of country, culture, background factors, or measurement instrument. Response Conversion (RC) based on Item Response Theory (IRT) was used to estimate such a common PA scale, to compare PA levels between countries, and to create a conversion key. Comparisons were made with Eurobarometer (IPAQ) data. Results: Appropriateness of IRT was supported by the existence of a strong first dimension established by principal component analysis. The IRT analysis resulted in 1 common PA scale with a reasonable fit and face validity. However, evidence for cultural bias (Differential Item Functioning, DIF) was found in all IPAQ items. This result made actual comparison between countries difficult. Conclusions: Response Conversion can improve comparability in the field of PA. RC needs common items that are culturally unbiased. Wide-scale use of RC awaits measures that are more culturally invariant (such as international accelerometer data). © 2012 Human Kinetics, Inc

In the Eye of the Beholder:Changes in Perceived Emotion Expression after Smile Reanimation

Background: Tools to quantify layperson assessments of facial palsy are lacking. In this study, artificial intelligence was applied to develop a proxy for layperson assessments, and compare sensitivity to existing outcome measures. Methods: Artificially intelligent emotion detection software was used to develop the emotionality quotient. The emotionality quotient was defined as the percentage probability of perceived joy over the percentage probability of perceived negative emotions during smiling, as predicted by the software. The emotionality quotient was used to analyze the emotionality of voluntary smiles of normal subjects and unilateral facial palsy patients before and after smile reanimation. The emotionality quotient was compared to oral commissure excursion and layperson assessments of facial palsy patients. Results: In voluntary smiles of 10 normal subjects, 100 percent joy and no negative emotion was detected (interquartile ranges, 0/1). Median preoperative emotionality quotient of 30 facial palsy patients was 15/-60 (interquartile range, 73/62). Postoperatively, median emotionality quotient was 84/0 (interquartile range, 28/5). In 134 smile reanimation patients, no correlation was found between postoperative oral commissure excursion and emotionality quotient score. However, in 61 preoperative patients, a moderate correlation was found between layperson-assessed disfigurement and negative emotion perception (correlation coefficient, 0.516; p <0.001). Conclusions: Computer vision artificial intelligence software detected less joy and more negative emotion in smiles of facial palsy patients compared with normal subjects. Following smile reanimation, significantly more joy and less negative emotion were detected. The emotionality quotient was correlated with layperson assessments. The simplicity, sensitivity, and objectivity of the emotionality quotient render it an attractive tool to serve as a potential proxy for layperson assessment, an ideal outcome measure in facial palsy

The effect of chronic quercetin supplementation on bone health in postmenopausal women: A double-blind placebo-controlled investigation

Currently, there is limited research investigating the effects of quercetin on bone turnover and density. Therefore, this study aimed to examine the efficacy of 90-day quercetin supplementation on bone turnover, inflammation, body composition, and physical function in postmenopausal women. Thirty-four healthy postmenopausal women (59.2 ± 7.0 yrs, 80.7 ± 15.6 kg, 29.8 ± 6.1 kg⸱m2) participated in the double-blind placebo-controlled investigation. Participants were randomly assigned to one of two groups: 500 mg of Q or 500 mg of fiber (placebo; PLB). Data collected during the pre-and post-supplementation assessments included: bone turnover (osteocalcin, P1NP, CTX), inflammation markers (IL-6, TNF-alpha, CRP), body composition, dominant handgrip strength, and timed up and go test. Independent samples t-tests were used for between-group comparisons of baseline values and the percent change for each dependent variable. A significant difference in percent change for osteocalcin (Q: 20.5±25.7; PLB: 1.3±17.2; p=0.016; d=0.89), P1NP (Q: 28.9 (6.0–57.3); PLB: 4.6 (-7.6 – 8.5); p=0.030; d=0.64), and CTX (Q: 39.0 (-10.0 – 84.6); PLB: -7.74 (-28.9 – 18.5); p=0.023; d=0.91) was found between Q and PLB, with greater increases in Q. Changes in the inflammation markers IL-6 (Q: -17.6±24.1; PLB: 2.90±31.1; p=0.045; d=0.73) and TNF-alpha (Q: -4.9± (-15.3 – [-3.2]); PLB: 1.9 (-7.8 – 4.0); p=0.021; d=0.90) between the two groups were significant. No significant changes were found between groups for CRP, body composition, and physical function (p\u3e0.05). The data suggest that Q may improve bone health status in postmenopausal women through its ability to decrease pro-inflammatory mediators and increase turnover markers

The Bradley–Terry regression trunk approach for modeling preference data with small trees

This paper introduces the Bradley-Terry regression trunk model, a novel probabilistic approach for the analysis of preference data expressed through paired comparison rankings. In some cases, it may be reasonable to assume that the preferences expressed by individuals depend on their characteristics. Within the framework of tree-based partitioning, we specify a tree-based model estimating the joint effects of subject-specific covariates over and above their main effects. We, therefore, combine a tree-based model and the log-linear Bradley-Terry model using the outcome of the comparisons as response variable. The proposed model provides a solution to discover interaction effects when no a-priori hypotheses are available. It produces a small tree, called trunk, that represents a fair compromise between a simple interpretation of the interaction effects and an easy to read partition of judges based on their characteristics and the preferences they have expressed. We present an application on a real dataset following two different approaches, and a simulation study to test the model's performance. Simulations showed that the quality of the model performance increases when the number of rankings and objects increases. In addition, the performance is considerably amplified when the judges' characteristics have a high impact on their choices.Multivariate analysis of psychological dat

Measuring determinants of implementation behavior: psychometric properties of a questionnaire based on the theoretical domains framework

BACKGROUND: To be able to design effective strategies to improve healthcare professionals’ implementation behaviors, a valid and reliable questionnaire is needed to assess potential implementation determinants. The present study describes the development of the Determinants of Implementation Behavior Questionnaire (DIBQ) and investigates the reliability and validity of this Theoretical Domains Framework (TDF)-based questionnaire. METHODS: The DIBQ was developed to measure the potential behavioral determinants of the 12-domain version of the TDF (Michie et al., 2005). We identified existing questionnaires including items assessing constructs within TDF domains and developed new items where needed. Confirmatory factor analysis was used to examine whether the predefined structure of the TDF-based questionnaire was supported by the data. Cronbach’s alpha was calculated to assess internal consistency reliability of the questionnaire, and domains’ discriminant validity was investigated. RESULTS: We developed an initial questionnaire containing 100 items assessing 12 domains. Results obtained from confirmatory factor analysis and Cronbach’s alpha resulted in the final questionnaire consisting of 93 items assessing 18 domains, explaining 63.3% of the variance, and internal consistency reliability values ranging from .68 to .93. Domains demonstrated good discriminant validity, although the domains ‘Knowledge’ and ‘Skills’ and the domains ‘Skills’ and ‘Social/professional role and identity’ were highly correlated. CONCLUSIONS: We have developed a valid and reliable questionnaire that can be used to assess potential determinants of healthcare professional implementation behavior following the theoretical domains of the TDF. The DIBQ can be used by researchers and practitioners who are interested in identifying determinants of implementation behaviors in order to be able to develop effective strategies to improve healthcare professionals’ implementation behaviors. Furthermore, the findings provide a novel validation of the TDF and indicate that the domain ‘Environmental context and resources’ might be divided into several environment-related domains

Condensation/immersion mode ice-nucleating particles in a boreal environment

Ice-nucleating particle (INP) measurements were performed in the boreal environment of southern Finland at the Station for Measuring Ecosystem-Atmosphere Relations (SMEAR II) in the winter-spring of 2018. Measurements with the Portable Ice Nucleation Chamber (PINC) were conducted at 242 K and 105 % relative humidity with respect to water. The median INP number concentration [INP] during a 6-week measurement period was 13 L-1. The [INP] spanned 3 orders of magnitude and showed a general increase from mid-February until early April. No single dominant local or regional sources of INPs in the boreal environment of southern Finland could be identified. Rather, it is hypothesised that the INPs detected at SMEAR II are a result of long-range transport and dilution of INPs sourced far from the measurement site. Despite high variability, the measured [INP] values fall within the range expected for the [INP] measured elsewhere under similar thermodynamic conditions. The [INP] did not correlate with any of the examined parameters during the entire field campaign, indicating that no one single parameter can be used to predict the [INP] at the measurement location during the examined time period. The absence of a correlation across the entire field campaign also suggests that a variety of particles act as INPs at different times, although it was indirectly determined that ambient INPs are most likely within the size range of 0.1-0.5 mu m in diameter on average. On shorter timescales, several particle species correlated well with the [INP]. Depending on the meteorological conditions, black carbon (BC), supermicron biological particles and sub-0.1 mu m particles, most likely nanoscale biological fragments such as ice-nucleating macromolecules (INMs), correlated with the INP signal. However, an increase in the concentration of any of these particle species may not necessarily lead to the increase in the [INP]; the reasons for this remain unknown. Limitations of the instrumental set-up and the necessity for future field INP studies are addressed.Peer reviewe

Integrating geoarchaeological techniques to reveal the invisible stratigraphy at Umhlatuzana rockshelter, South Africa: a grid-based approach

Umhlatuzana rockshelter is an archaeological site with an occupational record spanning the last ~70,000 years, covering the Middle Stone Age (MSA), Later Stone Age (LSA), and Iron Age. The deposits bearing Pleistocene archaeological assemblages at Umhlatuzana rockshelter appear homogeneous with no macroscopically visible stratigraphic boundaries. This means the integrity of the archaeological assemblages is difficult to ascertain. Moreover, the sedimentation rate, taphonomic history, and the environmental context across the sequence are unclear. This study aims to resolve these issues by integrating different geoarchaeological techniques in order to explore fine-resolution geochemical differentiations of the sediments that are macroscopically invisible. Samples were systematically retrieved from the western profile of the site following a grid-based sampling strategy and analysed for pH, elemental composition (XRF), and Magnetic Susceptibility. These methods were chosen because they provide insight into ‘invisible’ geoarchaeological dynamics, related to sediment input (geogenic and anthropogenic), taphonomy, and environmental conditions. Additionally, the results were integrated with preliminary micromorphological observations. Our study reveals a gradual change in the geochemistry of the deposits throughout the Pleistocene, related to a combination of environmental change and occupation intensity. Furthermore, the gradual change within the geochemical data indicates that no large-scale sediment mixing took place (contrary to previous suggestions), while small-scale mixing related to bioturbation is visible in the micromorphological thin sections. Our study offers a successful multi-proxy approach to systematically sample and analyse archaeological deposits at the macro and micro scale, integrating a variety of geoarchaeological techniques. The approach provides insight into the depositional and postdepositional history of the site, and allows questions of stratigraphic integrity, anthropogenic input, preservation, and environmental change to be addressed.NWOVidi 276-60-004Human Origin

Making the invisible stratigraphy visible: a grid-based, multi-proxy geoarchaeological study of Umhlatuzana rockshelter, South Africa

Umhlatuzana rockshelter is an archaeological site with an occupational record covering the Middle Stone Age, Later Stone Age, and Iron Age. The presence of both Middle and Later Stone Age assemblages makes Umhlatuzana the ideal location for the study of the MSA-LSA transition (20-40 ka) in southern Africa. This transitional period is characterized by important modifications in stone tool technology, from prepared core technology to a toolkit based on microlith production. These changes are argued to have occurred in response to changes in climate and environment leading up to the Last Glacial Maximum. The deposits bearing the transitional assemblages at Umhlatuzana rockshelter appear homogeneous with no visible stratigraphic boundaries. This study integrates geoarchaeological techniques in order to explore fine-resolution geochemical differentiations of the sediments that are macroscopically invisible, and that will provide insight into (post-)depositional processes over time. Samples were systematically retrieved from the western profile of the site following a grid-based sampling strategy and analyzed for pH, elemental composition (XRF), and Magnetic Susceptibility. Additionally, the results were integrated with preliminary micromorphological observations. Our study reveals a steady, gradual change in the geochemistry of the deposits throughout the Pleistocene, related to a combination of environmental change and occupation intensity. We suggest that the part of the sequence reported to bear Middle to Later Stone Age transitional industries is characterized by wetter environmental conditions compared to the underlying deposits. Additionally, we support results from previous studies that excluded large scale post-depositional movement of the sedimentary sequence. Our study offers a successful multi-proxy approach to systematically sample and study archaeological deposits at the macro and micro scale, integrating a variety of geoarchaeological techniques. The approach provides insight into the depositional and post-depositional history of the site, and allows for questions of stratigraphic integrity, anthropogenic input, preservation, and environmental change to be addressed.Thrombosis and Hemostasi