172 research outputs found

    The stochastic order of probability measures on ordered metric spaces

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    The general notion of a stochastic ordering is that one probability distribution is smaller than a second one if the second attaches more probability to higher values than the first. Motivated by recent work on barycentric maps on spaces of probability measures on ordered Banach spaces, we introduce and study a stochastic order on the space of probability measures P(X)\mathcal{P}(X), where XX is a metric space equipped with a closed partial order, and derive several useful equivalent versions of the definition. We establish the antisymmetry and closedness of the stochastic order (and hence that it is a closed partial order) for the case of a partial order on a Banach space induced by a closed normal cone with interior. We also consider order-completeness of the stochastic order for a cone of a finite-dimensional Banach space and derive a version of the arithmetic-geometric-harmonic mean inequalities in the setting of the associated probability space on positive matrices.Comment: 25 page

    Movement kinematics and proprioception in post-stroke spasticity: assessment using the Kinarm robotic exoskeleton

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    Background Motor impairment after stroke interferes with performance of everyday activities. Upper limb spasticity may further disrupt the movement patterns that enable optimal function; however, the specific features of these altered movement patterns, which differentiate individuals with and without spasticity, have not been fully identified. This study aimed to characterize the kinematic and proprioceptive deficits of individuals with upper limb spasticity after stroke using the Kinarm robotic exoskeleton. Methods Upper limb function was characterized using two tasks: Visually Guided Reaching, in which participants moved the limb from a central target to 1 of 4 or 1 of 8 outer targets when cued (measuring reaching function) and Arm Position Matching, in which participants moved the less-affected arm to mirror match the position of the affected arm (measuring proprioception), which was passively moved to 1 of 4 or 1 of 9 different positions. Comparisons were made between individuals with (n = 35) and without (n = 35) upper limb post-stroke spasticity. Results Statistically significant differences in affected limb performance between groups were observed in reaching-specific measures characterizing movement time and movement speed, as well as an overall metric for the Visually Guided Reaching task. While both groups demonstrated deficits in proprioception compared to normative values, no differences were observed between groups. Modified Ashworth Scale score was significantly correlated with these same measures. Conclusions The findings indicate that individuals with spasticity experience greater deficits in temporal features of movement while reaching, but not in proprioception in comparison to individuals with post-stroke motor impairment without spasticity. Temporal features of movement can be potential targets for rehabilitation in individuals with upper limb spasticity after stroke.York University Librarie

    Rinderpest eradicated

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    Rinderpest caused hundreds of millions of animal deaths that preceded famines in Africa, Asia, and Europe. After centuries of efforts to prevent outbreaks of the disease, international authorities announced in May that the disease was the second, after smallpox, to be eradicated through human efforts.Originally published as HTML file, converted to PDF with Adobe Acrobat 9 Pro Version 9.0.0

    Post laryngoplasty ultrasonography of the horse larynx

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    Laryngoplasty is commonly used to treat laryngeal hemiplegia in Thoroughbred racehorses and success and evaluation thereof has traditionally been determined using endoscopy with little emphasis on ultrasonography. Laryngeal ultrasonography can easily be performed in the standing unsedated horse and is relatively inexpensive. Ultrasonography of the normal horse larynx has been described, as have a number of pathological conditions that occur in the laryngeal and pharyngeal area. Postsurgical ultrasonographic evaluation of laryngoplasty has limited coverage in the literature and is limited to individual cases. The aim of the investigation was to evaluate and validate the use of transcutaneous ultrasonography in horses following laryngoplasty, as well as improving our understanding of the healing process and detecting postsurgical complications. Laryngeal hemiplegia is a relatively common condition and is of particular importance in Thoroughbred racehorses. Traditionally, postsurgical laryngoplasty management and success has been determined by, and monitored with, resting upper respiratory endoscopy. This modality is limited in that peri- and non-luminal laryngeal structures cannot be assessed. A prospective case series of 10 Thoroughbred racehorses with left recurrent laryngeal hemiplegia was examined prior to, 3-10 days, 30-50 days and 6-12 months after laryngoplasty and ventriculectomy, using transcutaneous ultrasonography and endoscopy. Arytenoid abduction was graded endoscopically at each of the examination times using the Havemeyer system for presurgery and the Dixon system postsurgery. The following measurements were made ultrasonographically: cricoarytenoideus lateralis muscle widest diameter, circumference and cross-sectional area; the distance between the vocal folds in exhalation and inhalation, basihyoid depth, rostral thyroid cartilage depth, and distance between the basihyoid and thyroid cartilage was also measured. The ultrasonographically visible presence or absence of the laryngeal ventricles was determined as well as the degree of laryngeal movement as absent, present or intermediate. Repeated means ANOVA was conducted on the ultrasonographic measurements at the four examination times with significance set at P < 0.05. Descriptive analyses on the vocal fold and arytenoid cartilage movement and visibility of the ventricles was performed. It was determined that the structures described in a normal laryngeal ultrasonographic examination could be seen postsurgically. Postsurgical complications of laryngoplasty in the extra-luminal structures were found in seven horses and included soft tissue swelling, seroma formation and one case of marked subcutaneous haemorrhage. In addition a luminal vocal fold abscess and vocal fold granuloma were detected. It was possible to visualise the presence or absence of a ventricular opening ultrasonographically in 70 % of postsurgical horses. The presence of the laryngeal prosthesis suture material was possible to determine in the healing tissues when metallic clips were used, but visualization of other material proved difficult. The distance between the vocal folds in exhalation over the long term was significantly larger than presurgically (1.00 ± 0.24 cm vs 0.67 ± 0.11 cm). The presurgical exhalation distance was also significantly increased from the 30-50 days mean. In addition, the comparison of vocal fold inhalation and exhalation distances at presurgery, 3-10 days postsurgery, 30-50 days postsurgery and at 6-12 months were all significantly different. When compared over time, the mean presurgical inhalation and exhalation means (1.09 ± 0.32 cm and 0.78 ± 0.28 cm, respectively) were significantly smaller than the 6-12 month inhalation and exhalation means, the 3-10 day means were significantly smaller than the 6-12 month inhalation and exhalation means, and the 3-10 day means were significantly smaller than the 30-50 day over time with an increase in the distance as healing progressed. Vocal fold and arytenoid cartilage movement was easy to evaluate ultrasonographically and appeared to correlate to the endoscopic grading, although the latter was not measured. Caudal basihyoid bone depth means in the medium term were significantly different between 3-10 days postsurgery (1.85 ± 0.28 cm) and 30-50 days postsurgery (1.64 ± 0.14 cm). Over the long term the presurgical mean (1.62 ± 0.24 cm) was significantly less than 3-10 days postsurgery mean (1.93 ± 32 cm) and the latter mean was significantly larger than the 30-50 days postsurgery mean (1.66 ± 0.13 cm). In addition the 3-10 days and 6-12 month postsurgery means were also significantly different (1.93 ± 0.24 cm vs 1.60 ± 0.14 cm). Rostral thyroid cartilage depth means in the medium term at 3-10 days postsurgery (3.67 ± 0.53 cm) were significantly larger than 30-50 days postsurgery (3.24 ± 0.48 cm). These differences were most likely as a result of tissue swelling related to the surgery because the laryngoplasty and ventriculectomy had no influence on these structures: the 6-12 month postsurgery values are very similar to the presurgical values. No significant differences in any of the measurements of the cricoarytenoideus lateralis muscle were found at any measurement. Future studies need to be performed with a larger sample size to establish a baseline of vocal fold excursion distance measurement to enable them to be used as a grading system for ultrasonographically evaluating the success of a laryngoplasty in the post laryngoplasty /ventriculectomy horse. Additional objective endoscopic measurements of vocal fold excursion with correlation to ultrasonographic measurements also need to be performed. Ultrasound is an easily accessible tool for most practitioners and can be used for, and will allow, easy evaluation of the post laryngoplasty larynx in the horse in assessing both the success (based on abduction grade) of the procedure, monitoring healing and detecting complications early in order to institute treatment early.Dissertation (MSc)--University of Pretoria, 2018.Companion Animal Clinical StudiesMScUnrestricte

    Considerations for multi-centre conditioned pain modulation (CPM) research; an investigation of the inter-rater reliability, level of agreement and confounders for the Achilles tendon and Triceps Surae

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    © The British Pain Society 2020. Objective: This study aimed to investigate the inter-rater reliability of the conditioned pain modulation (CPM) effect. Methods: The reliability between two examiners assessing the CPM effect via pressure pain thresholds and induced using the cold pressor test of 28 healthy volunteers at the mid-portion Achilles tendon (AT) and Triceps Surae musculotendinous junction was performed. Reliability was calculated using intraclass correlation coefficient (ICC). Confounders were assessed using multivariable generalised estimating equations (GEEs). Bias in the level of agreement was assumed if the confidence intervals (CIs) of the mean difference in Bland–Altman plots did not cross the line of equality. Results: The inter-rater reliability of the CPM effect was poor to moderate in the AT (ICC 95% CI = 0.00–0.66) and Triceps Surae (ICC 95% CI = 0.00–0.69). However, when accounting for confounders within the GEE, there were no differences between testers and Bland–Altman plots reported good agreement between testers. Habitual completion of running-related physical activity was a confounder for both the AT parallel-paradigm (p = 0.017) and sequential-paradigm (p = 0.029). Testing order was a confounder for the AT (p = 0.023) and Triceps Surae (p = 0.014) parallel-paradigm. Conclusion: This study suggests the CPM effect may be site specific (i.e. differences between the AT and Triceps Surae exist). In addition, differences in the reliability between examiners are likely due to the influence of confounders and not examiner technique and therefore appropriate analysis should be used in research investigating the CPM effect

    Worldwide patterns of haplotype diversity at 9p21.3, a locus associated with type 2 diabetes and coronary heart disease

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    A 100 kb region on 9p21.3 harbors two major disease susceptibility loci: one for type 2 diabetes (T2D) and one for coronary heart disease (CHD). The single nucleotide polymorphisms (SNPs) associated with these two diseases in Europeans reside on two adjacent haplotype blocks with independent effects on disease. To help delimit the regions that likely harbor the disease-causing variants in populations of non-European origin, we studied the haplotype diversity and allelic history of the 9p21.3 region using 938 unrelated individuals from 51 populations (Human Genome Diversity Panel). We used SNP data from Illumina's 650Y SNP arrays supplemented with five additional SNPs within the region of interest. Haplotype frequencies were analyzed with the EM algorithm implemented in PLINK. For the T2D locus, the TT risk haplotype of SNPs rs10811661 and rs10757283 was present at similar frequencies in all global populations, while a shared 6-SNP haplotype that carries the protective C allele of rs10811661 was found at a frequency of 2.9% in Africans and 41.3% in East Asians and was associated with low haplotype diversity. For the CHD locus, all populations shared a core risk haplotype spanning >17.5 kb, which shows dramatic increase in frequency between African (11.5%) and Middle Eastern (63.7%) populations. Interestingly, two SNPs (rs2891168 and rs10757278) tagging this CHD risk haplotype are most strongly associated with CHD disease status according to independent clinical fine-mapping studies. The large variation in linkage disequilibrium patterns identified between the populations demonstrates the importance of allelic background data when selecting SNPs for replication in global populations. Intriguingly, the protective allele for T2D and the risk allele for CHD show an increase in frequency in non-Africans compared to Africans, implying different population histories for these two adjacent disease loci

    Assessment and monitoring of Achilles tendinopathy in clinical practice: A qualitative descriptive exploration of the barriers clinicians face

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    Our primary objective was to explore the barriers preventing clinicians from implementing what they think is ideal practice as it relates to using tools to aid diagnosis and monitor progress in mid-portion Achilles tendinopathy. Our secondary objectives were to describe the assessments employed by clinicians in their own practice to aid with (a) diagnosis and (b) monitoring progress in Achilles tendinopathy and explore the outcome measure domains clinicians believe to be the most and least important when managing patients with Achilles tendinopathy. We employed a qualitative descriptive study design. Thirteen participants (eight female, five male) from across Australia, consisting of two junior physiotherapists, five senior physiotherapists working in private practice, four senior physiotherapists working within elite sports organisations and two sport and exercise medicine doctors, were included and one-on-one interviews were performed. Audio was transcribed then entered into NVivo for coding and analysis. Four main themes were perceived as barriers to implementing ideal practice of assessment and monitoring in people with Achilles tendinopathy: financial constraints, time constraints, access to equipment and patient symptom severity. Assessments related to function, pain on loading, pain over a specified time frame and palpation are commonly used to assist diagnosis. Assessments related to disability, pain on loading, pain over a specified time frame and physical function capacity are used to monitor progress over time. Furthermore, pain on loading and pain over a specified time frame were considered the most important outcome measure domains for assisting diagnosis whereas pain on loading, patient rating of the condition and physical function capacity were the most important outcome measure domains for monitoring progress. A number of barriers exist that prevent clinicians from implementing what they view as ideal assessment and monitoring for Achilles tendinopathy. These barriers should be considered when developing new assessments and in clinical practice recommendations

    Can we really say getting stronger makes your tendon feel better? No current evidence of a relationship between change in Achilles tendinopathy pain or disability and changes in Triceps Surae structure or function when completing rehabilitation: A systematic review

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    Objectives: Determine if improvements in pain and disability in patients with mid-portion Achilles tendinopathy relate to changes in muscle structure and function whilst completing exercise rehabilitation. Design: A systematic review exploring the relationship between changes in pain/disability and muscle structure/function over time, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Methods: Six online databases and the grey literature were searched from database inception to 16th December 2022 whereas clinical trial registries were searched from database inception to 11th February 2020. We included clinical studies where participants received exercise rehabilitation (± placebo interventions) for mid-portion Achilles tendinopathy if pain/disability and Triceps Surae structure/function were measured. We calculated Cohen\u27s d (95 % confidence intervals) for changes in muscle structure/function over time for individual studies. Data were not pooled due to heterogeneity. Study quality was assessed using a modified Newcastle–Ottawa Scale. Results: Seventeen studies were included for synthesis. No studies reported the relationship between muscle structure/function and pain/disability changes. Twelve studies reported muscle structure/function outcome measures at baseline and at least one follow-up time-point. Three studies reported improvements in force output after treatment; eight studies demonstrated no change in structure or function; one study did not provide a variation measure, precluding within group change over time calculation. All studies were low quality. Conclusions: No studies explored the relationship between changes in tendon pain and disability and changes in muscle structure and function. It is unclear whether current exercise-based rehabilitation protocols for mid-portion Achilles tendinopathy improve muscle structure or function. Systematic review registration: PROSPERO (registration number: CRD42020149970)

    The Impact of Light Pollution on Observational Resources

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    The 1-meter telescope at the Embry-Riddle Aeronautical University Daytona Beach campus is the largest university-based research telescope in Florida. In ideal conditions, it should have some of the best observational abilities in the state. However, the light pollution and lighting practices from facilities and outdoor light fixtures greatly interfere with these abilities. Our team works to identify the greatest contributors to light pollution on campus so that we can develop cost effective and accessible solutions to increase the quality of our data. The results of this project will be shared with Embry-Riddle Aeronautical University leadership in hopes that improvements can be made. Using a Unihedron Sky Quality Meter, we measured the severity of the light pollution under various locations and conditions. These conditions include measurements with and without temporary light covers, yellow cellophane light filters, and shades applied to the Mori Hosseini Student Union. We additionally compare spectroscopy data analysis from before and after the construction of the Mori Hosseini Student Union. Our project is new, and therefore ongoing. We require more data to thoroughly investigate our results before reporting our findings. However, as of now, our preliminary analysis suggests that improvements to the lighting practices around the College of Arts and Sciences, particularly with the Mori Hosseini Student Union, would greatly enhance the capabilities of the 1-meter telescope. Using covers on outdoor light fixtures to redirect light and using yellow light filters have been shown to reduce the light pollution. The final solution is still currently under investigation
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