Validation of a Novel Physical Activity Assessment Device in Morbidly Obese Females

Assessment of physical activity in morbidly obese subjects is important especially in bariatric surgery. We examined the validity of Intelligent Device for Energy Expenditure and Activity (IDEEA) for measuring physical activity and sedentary behavior in morbidly obese women. Activity types, gait counts, and speed detected by the IDEEA monitor were compared to those reported by an observer. The IDEEA monitor detected activity types and gait counts with relatively high accuracy, although slightly lower in extremely obese women than in normal weight controls. The IDEEA monitor accurately estimated gait speeds in both groups. Since gait speed predicts energy expenditure more accurately than gait counts, it is of greater clinical relevance. Reliability of the IDEEA monitor was excellent. The IDEEA monitor is a valid instrument for measuring physical activity and sedentary behavior in extremely obese women, and therefore has potential applications in bariatric surgery both in preoperative evaluation and long-term follow-up

Size Threshold Perimetry Performs as Well as Conventional Automated Perimetry With Stimulus Sizes III, V, and VI for Glaucomatous Loss

Citation: Wall M, Doyle CK, Eden T, Zamba KD, Johnson CA. Size threshold perimetry performs as well as conventional automated perimetry with stimulus sizes III, V, and VI for glaucomatous loss. Invest Ophthalmol Vis Sci. 2013;54:3975-3983. DOI:10. 1167/iovs.12-11300 PURPOSE. It is thought that large perimetric stimuli are insensitive for demonstrating visual field defects. To test the hypothesis that there is no difference in the total number of abnormal test locations with total deviation empiric probability plots in glaucoma patients, we compared results of glaucoma patients tested with sizes III (0.438 diameter), V (1.728), and VI (3.448), and size threshold perimetry (STP), a method that finds threshold by changing stimulus size. METHODS. We derived normative limits for total deviation probability plots using the second test from 60 age-matched normals. We analyzed the probability plots of 120 glaucoma patients (mean deviation was À9.3 6 6.1 dB with a range of À0.2 to À31.6) at the 42 nonblind spot locations common to the tests. We compared the number of abnormal test locations at the 5% level among the tests using one-way repeated measures ANOVA on ranks. We stratified the results by mean deviation. RESULTS. There was a statistically significant difference in the number of abnormal test locations among the tests: III, 28.5; V, 29.7; VI, 27.0; and STP, 28.8, P ¼ 0.001; Tukey pairwise comparisons were statistically significant for the assessments between sizes V and VI and between STP and size VI. When stratifying by mean deviation, with mild visual loss, size V was most sensitive, followed by STP; size VI appeared slightly less sensitive. CONCLUSIONS. Size V and STP provide favorable stimulus methodology for detection of mild to moderate glaucoma. Size VI appears slightly less sensitive for glaucoma with mild loss. Keywords: perimetry, visual testing, visual field, vision testing, stimulus size C onventional automated perimetry, since its introduction in the late 1970s, has almost exclusively used the Goldmann size III stimulus. However, it has been shown that detection of defects from glaucoma and other optic neuropathies can be done at least as well with larger stimuli. 1,2 In addition, these large stimuli have been shown to give better retest variability and extend the dynamic range of the test. 5 However, the original 108 frequency doubling technology stimulus is over 40 times the size of the 1.78 size V stimulus in area and Frequency Doubling Technology (FDT) testing is similar in sensitivity to conventional automated perimetry using a size III stimulus (0.438) for glaucoma and other optic neuropathies

Environmental Influences on Fish Species Distribution in the Musolo River System, Congo River Basin (Democratic Republic of the Congo, Central Africa)

Ichthyofaunal distribution was studied in the Musolo River system, a small affluent tributary of the Congo River flowing into Pool Malebo (Democratic Republic of the Congo). Twelve ecological stations were sampled, of which eight were located in the Musolo main-channel and four in the Fushi River, a principal tributary of the Musolo. Each station was sampled four times over a two-year period, with fishing techniques following standardized methods utilizing dip and cast nets, and nine environment variables were measured at each station. Fifty-three fish species belonging to 36 genera and 16 families were collected with the Alestidae, Distichodontidae, Cichlidae, Cyprinidae, Mormyridae, and Mochokidae being the most diversified. Redundancy Analysis with forward selection coupled with Monte Carlo permutation tests (499 permutations) identified total dissolved solid (25.8%) and altitude (24.4%) as accounting for 50.2% of total variance (p < 0.05). The contribution of the two first axes was significant (F = 3.41; p = 0.004). Species richness increases from upstream to downstream. In general, the high value of Shannon’s diversity (1.07-2.67) and Equitability European Scientific Journal November 2019 edition Vol.15, No.33 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 193 (0.62-0.96) indices at all sites, indicates that the examined stretch of the Musolo River system is in good ecological health, despite its location adjacent to the megacity of Kinshasa

A comprehensive analysis of the epidemiology and clinical characteristics of anti-LRP4 in myasthenia gravis

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PDXK mutations cause polyneuropathy responsive to pyridoxal 5'-phosphate supplementation.

OBJECTIVE: To identify disease-causing variants in autosomal recessive axonal polyneuropathy with optic atrophy and provide targeted replacement therapy. METHODS: We performed genome-wide sequencing, homozygosity mapping, and segregation analysis for novel disease-causing gene discovery. We used circular dichroism to show secondary structure changes and isothermal titration calorimetry to investigate the impact of variants on adenosine triphosphate (ATP) binding. Pathogenicity was further supported by enzymatic assays and mass spectroscopy on recombinant protein, patient-derived fibroblasts, plasma, and erythrocytes. Response to supplementation was measured with clinical validated rating scales, electrophysiology, and biochemical quantification. RESULTS: We identified biallelic mutations in PDXK in 5 individuals from 2 unrelated families with primary axonal polyneuropathy and optic atrophy. The natural history of this disorder suggests that untreated, affected individuals become wheelchair-bound and blind. We identified conformational rearrangement in the mutant enzyme around the ATP-binding pocket. Low PDXK ATP binding resulted in decreased erythrocyte PDXK activity and low pyridoxal 5'-phosphate (PLP) concentrations. We rescued the clinical and biochemical profile with PLP supplementation in 1 family, improvement in power, pain, and fatigue contributing to patients regaining their ability to walk independently during the first year of PLP normalization. INTERPRETATION: We show that mutations in PDXK cause autosomal recessive axonal peripheral polyneuropathy leading to disease via reduced PDXK enzymatic activity and low PLP. We show that the biochemical profile can be rescued with PLP supplementation associated with clinical improvement. As B6 is a cofactor in diverse essential biological pathways, our findings may have direct implications for neuropathies of unknown etiology characterized by reduced PLP levels. ANN NEUROL 2019;86:225-240

Mitochondrial superclusters influence age of onset of Parkinson’s disease in a gender specific manner in the Cypriot population: A case-control study

Despite evidence supporting an involvement of mitochondrial dysfunction in the pathogenesis of some neurodegenerative disorders, there are inconsistent findings concerning mitochondrial haplogroups and their association to neurodegenerative disorders, including idiopathic Parkinson's disease (PD).To test this hypothesis for the Greek-Cypriot population, a cohort of 230 PD patients and 457 healthy matched controls were recruited. Mitochondrial haplogroup distributions for cases and controls were determined. Association tests were carried out between mitochondrial haplogroups and PD.Mitochondrial haplogroup U was associated with a reduced PD risk in the Cypriot population. After pooling mitochondrial haplogroups together into haplogroup clusters and superclusters, association tests demonstrated a significantly protective effect of mitochondrial haplogroup cluster N (xR) and supercluster LMN for PD risk only in females. In addition, for female PD cases belonging to UKJT and R (xH, xUKJT) haplogroup, the odds of having a later age of onset of PD were 13 and 15 times respectively higher than the odds for female cases with an H haplogroup.Statistically significant associations regarding PD risk and PD age of onset were mostly detected for females thus suggesting that gender is a risk modifier between mitochondrial haplogroups and PD status / PD age of onset. The biological mechanisms behind this gender specificity remain to be determined

Sequential detection framework for real-time biosurveillance based on Shiryaev-Roberts procedure with illustrations using COVID-19 incidence data

This article develops a detection framework using Bayesian philosophy by adaptation of Shiryaev's and Roberts' methodology. We propose two unifying versions directly applicable in industrial process control and easily extendable to public health infectious disease surveillance via some data detrending and/or demodulation. The root idea uses the sum of likelihood ratios upon which an optimal stopping criterion is based. It sets a prior on the epoch of a change, allows the flexibility to elicit a prior distribution on other process parameters, and attempts to minimize an expected loss function. A sensitivity analysis is conducted for validation and performance assessment and analytical formulas are derived. The methods are successfully applied to the European Union Centre for Disease Control (ECDC) open-source global COVID-19 incidence data. We further lay out scenarios where interest may switch to the detection of separate outbreaks with similar syndromes during an already evolving epidemic. We view our approach as a toolkit with a potential to augment early reports to sentinels in syndromic surveillance and in biosurveillance

Parameter estimation for correlated recurrent events under informative monitoring

When subjects are monitored for a recurrent event over a period of time, each individual behaves like an experimental unit within which measurements may be correlated. The subject-specific observation window (i.e. monitoring period) constitutes another factor controlling the accumulation of events and censoring. We develop a procedure for estimating survivor parameters in the presence of joint effect of correlation and informative monitoring; specifically, for studies in which the survival time for a subject is censored because of deterioration of their physical condition or due to the accumulation of their event occurrences. In this manuscript, we approach the survivor parameter estimation problem by a fully parametric baseline hazard model where the intensity functions of the inter-event time and the duration of the monitoring period are reconciled through the generalized Koziol-Green (KG) model (Koziol and Green (1976) [12]), and the within experimental unit correlation modeled through frailty. We outline the Expectation Maximization (EM) steps for estimating Weibull parameters with correlated recurrent event data under informative monitoring. We apply our method to a real life data

A Chi-Squared Goodness of Fit Test For Recurrent Event Data

Goodness of fit of the distribution function governing the time to occurrence of a recurrent event is considered. We develop a chi-squared type of test (henceforward called ℜ test) based on a nonparametric maximum likelihood estimator (NPMLE) of the inter-event time distribution for recurrent events. The test compares a parametric null to the NPMLE over k partitions of a calendar time over the monitoring period. We investigate small sample and asymptotic properties of four variants of the test as well as power analysis against a sequence of Pitman’s alternatives. The conclusion that transpires from the finite sample simulation study is that significant level is achieved when the right-censoring random variable is not ignored and k ≥ 6. We consider and discuss simulation results for Exponential, Weibull and Lognormal lifetime models. We apply the ℜ test to a real-life recurrent event data

A Khmaladze-Transformed Test of Fit with ML Estimation in the Presence of Recurrent Events

This article provides a goodness-of-fit test for the distribution function or the survival function in a recurrent event setting, when the inter-event time parametric structure F( · ; θ) is estimated from the observed data. Of concern is the null hypothesis that the inter-event time distribution is absolutely continuous and belongs to a parametric family ℱ = {F(· ; θ) : θ ∈ Θ ⊆ ℜq} where the q-dimensional parameter space is neither known nor specified. We proposed a Khmaladze martingale-transformed type of test (Khmaladze, 1981), adapted to recurrent events. The test statistic combines two likelihood sources of estimation to form a parametric empirical process: (1) a product-limit nonparametric maximum likelihood estimator (NPMLE; Pena et al., 2001a) that is a consistent estimator of F, [F hat] say, and (2) a point process likelihood estimator F( · ;[θ hat] ) (Jacod, 1974/1975). These estimators are combined to construct a Kolmogorov-Smirnov (KS) type of test (Kolmogorov 1933; Smirnov, 1933). Empirical process and martingale weak convergence frameworks are utilized for theoretical derivations and motivational justification of the proposed transformation. A simulation study is conducted for performance assessment, and the test is applied to a problem investigated by Proschan (1963) on air-conditioning failure in a fleet of Boeing 720 jets