Applying the Minimal Detectable Change of a Static and Dynamic Balance Test Using a Portable Stabilometric Platform to Individually Assess Patients with Balance Disorders

Balance disorders have a high prevalence among elderly people in developed countries, and falls resulting from balance disorders involve high healthcare costs. Therefore, tools and indicators are necessary to assess the response to treatments. Therefore, the aim of this study is to detect relevant changes through minimal detectable change (MDC) values in patients with balance disorders, specifically with vertigo. A test-retest of a static and dynamic balance test was conducted on 34 healthy young volunteer subjects using a portable stabilometric platform. Afterwards, in order to show the MDC applicability, eight patients diagnosed with balance disorders characterized by vertigo of vestibular origin performed the balance test before and after a treatment, contrasting the results with the assessment by a specialist physician. The balance test consisted of four tasks from the Romberg test for static balance control, assessing dynamic postural balance through the limits of stability (LOS). The results obtained in the test-retest show the reproducibility of the system as being similar to or better than those found in the literature. Regarding the static balance variables with the lowest MDC value, we highlight the average velocity of the center of pressure (COP) in all tasks and the root mean square (RMS), the area, and the mediolateral displacement in soft surface, with eyes closed. In LOS, all COP limits and the average speed of the COP and RMS were highlighted. Of the eight patients assessed, an agreement between the specialist physician and the balance test results exists in six of them, and for two of the patients, the specialist physician reported no progression, whereas the balance test showed worsening. Patients showed changes that exceeded the MDC values, and these changes were correlated with the results reported by the specialist physician. We conclude that (at least for these eight patients) certain variables were sufficiently sensitive to detect changes linked to balance progression. This is intended to improve decision making and individualized patient monitoring

Learning Network Assisted by Means of Symbolic Computation

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Is my patient improving? Individualized gait analysis in rehabilitation

In the rehabilitation field, clinicians are continually struggling to assess improvements in patients following interventions. In this paper, we propose an approach to use gait analysis based on inertial motion capture (MoCap) to monitor individuals during rehabilitation. Gait is a cyclical movement that generates a sufficiently large data sample in each capture session to statistically compare two different sessions from a single patient. Using this crucial idea, 21 heterogeneous patients with hemiplegic spasticity were assessed using gait analysis before and after receiving treatment with botulinum toxin injections. Afterwards, the two sessions for each patient were compared using the magnitude-based decision statistical method. Due to the challenge of classifying changes in gait variables such as improvements or impairments, assessing each patient’s progress required an interpretative process. After completing this process, we determined that 10 patients showed overall improvement, five patients showed overall impairment, and six patients did not show any overall change. Finally, the interpretation process was summarized by developing guidelines to aid in future assessments. In this manner, our approach provides graphical information about the patients’ progress to assess improvement following intervention and to support decision-making. This research contributes to integrating MoCap-based gait analysis into rehabilitation

Hydrodynamic theory for granular gases

A granular gas subjected to a permanent injection of energy is described by means of hydrodynamic equations derived from a moment expansion method. The method uses as reference function not a Maxwellian distribution $f_{\sf M}$ but a distribution $f_0 = \Phi f_{\sf M}$, such that $\Phi$ adds a fourth cumulant $\kappa$ to the velocity distribution. The formalism is applied to a stationary conductive case showing that the theory fits extraordinarily well the results coming from our molecular dynamic simulations once we determine $\kappa$ as a function of the inelasticity of the particle-particle collisions. The shape of $\kappa$ is independent of the size $N$ of the system.Comment: 10 pages, 9 figures, more about our research in http://www.cec.uchile.cl/cinetica

Nocturnal Hypoxemia and CT Determined Pulmonary Artery Enlargement in Smokers

Background: Pulmonary artery enlargement (PAE) detected using chest computed tomography (CT) is associated with poor outcomes in chronic obstructive pulmonary disease (COPD). It is unknown whether nocturnal hypoxemia occurring in smokers, with or without COPD, obstructive sleep apnoea (OSA) or their overlap, may be associated with PAE assessed by chest CT. Methods: We analysed data from two prospective cohort studies that enrolled 284 smokers in lung cancer screening programs and completing baseline home sleep studies and chest CT scans. Main pulmonary artery diameter (PAD) and the ratio of the PAD to that of the aorta (PA:Ao ratio) were measured. PAE was defined as a PAD >= 29 mm in men and >= 27 mm in women or as a PA:Ao ratio > 0.9. We evaluated the association of PAE with baseline characteristics using multivariate logistic models. Results: PAE prevalence was 27% as defined by PAD measurements and 11.6% by the PA:Ao ratio. A body mass index >= 30 kg/m(2) (OR 2.01; 95%CI 1.06-3.78), lower % predicted of forced expiratory volume in one second (FEV1) (OR 1.03; 95%CI 1.02-1.05) and higher % of sleep time with O-2 saturation < 90% (T90) (OR 1.02; 95%CI 1.00-1.03), were associated with PAE as determined by PAD. However, only T90 remained significantly associated with PAE as defined by the PA:Ao ratio (OR 1.02; 95%CI 1.01-1.03). In the subset group without OSA, only T90 remains associated with PAE, whether defined by PAD measurement (OR 1.02; 95%CI 1.01-1.03) or PA:Ao ratio (OR 1.04; 95%CI 1.01-1.07). Conclusions: In smokers with or without COPD, nocturnal hypoxemia was associated with PAE independently of OSA coexistence

Methods for interpreting lists of affected genes obstained in a DNA microarray experiment

Background - The aim of this paper was to describe and compare the methods used and the results obtained by the participants in a joint EADGENE (European Animal Disease Genomic Network of Excellence) and SABRE (Cutting Edge Genomics for Sustainable Animal Breeding) workshop focusing on post analysis of microarray data. The participating groups were provided with identical lists of microarray probes, including test statistics for three different contrasts, and the normalised log-ratios for each array, to be used as the starting point for interpreting the affected probes. The data originated from a microarray experiment conducted to study the host reactions in broilers occurring shortly after a secondary challenge with either a homologous or heterologous species of Eimeria. Results - Several conceptually different analytical approaches, using both commercial and public available software, were applied by the participating groups. The following tools were used: Ingenuity Pathway Analysis, MAPPFinder, LIMMA, GOstats, GOEAST, GOTM, Globaltest, TopGO, ArrayUnlock, Pathway Studio, GIST and AnnotationDbi. The main focus of the approaches was to utilise the relation between probes/genes and their gene ontology and pathways to interpret the affected probes/genes. The lack of a well-annotated chicken genome did though limit the possibilities to fully explore the tools. The main results from these analyses showed that the biological interpretation is highly dependent on the statistical method used but that some common biological conclusions could be reached. Conclusion - It is highly recommended to test different analytical methods on the same data set and compare the results to obtain a reliable biological interpretation of the affected genes in a DNA microarray experimen

Chronic Obstructive Pulmonary Disease (COPD) as a disease of early aging: Evidence from the EpiChron Cohort

Background Aging is an important risk factor for most chronic diseases. Patients with COPD develop more comorbidities than non-COPD subjects. We hypothesized that the development of comorbidities characteristically affecting the elderly occur at an earlier age in subjects with the diagnosis of COPD. Methods and findings We included all subjects carrying the diagnosis of COPD (n = 27, 617), and a similar number of age and sex matched individuals without the diagnosis, extracted from the 727, 241 records of individuals 40 years and older included in the EpiChron Cohort (Aragon, Spain). We compared the cumulative number of comorbidities, their prevalence and the mortality risk between both groups. Using network analysis, we explored the connectivity between comorbidities and the most influential comorbidities in both groups. We divided the groups into 5 incremental age categories and compared their comorbidity networks. We then selected those comorbidities known to affect primarily the elderly and compared their prevalence across the 5 age groups. In addition, we replicated the analysis in the smokers'' subgroup to correct for the confounding effect of cigarette smoking. Subjects with COPD had more comorbidities and died at a younger age compared to controls. Comparison of both cohorts across 5 incremental age groups showed that the number of comorbidities, the prevalence of diseases characteristic of aging and network''s density for the COPD group aged 56-65 were similar to those of non-COPD 15 to 20 years older. The findings persisted after adjusting for smoking. Conclusion Multimorbidity increases with age but in patients carrying the diagnosis of COPD, these comorbidities are seen at an earlier age

Nucleon Polarizabilities from Deuteron Compton Scattering within a Green's-Function Hybrid Approach

We examine elastic Compton scattering from the deuteron for photon energies ranging from zero to 100 MeV, using state-of-the-art deuteron wave functions and NN-potentials. Nucleon-nucleon rescattering between emission and absorption of the two photons is treated by Green's functions in order to ensure gauge invariance and the correct Thomson limit. With this Green's-function hybrid approach, we fulfill the low-energy theorem of deuteron Compton scattering and there is no significant dependence on the deuteron wave function used. Concerning the nucleon structure, we use Chiral Effective Field Theory with explicit \Delta(1232) degrees of freedom within the Small Scale Expansion up to leading-one-loop order. Agreement with available data is good at all energies. Our 2-parameter fit to all elastic $\gamma d$ data leads to values for the static isoscalar dipole polarizabilities which are in excellent agreement with the isoscalar Baldin sum rule. Taking this value as additional input, we find \alpha_E^s= (11.3+-0.7(stat)+-0.6(Baldin)) x 10^{-4} fm^3 and \beta_M^s = (3.2-+0.7(stat)+-0.6(Baldin)) x 10^{-4} fm^3 and conclude by comparison to the proton numbers that neutron and proton polarizabilities are essentially the same.Comment: 47 pages LaTeX2e with 20 figures in 59 .eps files, using graphicx. Minor modifications; extended discussion of theoretical uncertainties of polarisabilities extraction. Version accepted for publication in EPJ