Comparison of Self-Report Versus Sensor-Based Methods for Measuring the Amount of Upper Limb Activity Outside the Clinic

Publication date: Available online 10 March 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Kimberly J. Waddell, Catherine E. Lang
ObjectiveTo compare self-reported with sensor-measured upper limb (UL) performance in daily life for individuals with chronic (≥6mo) UL paresis poststroke.DesignSecondary analysis of participants enrolled in a phase II randomized, parallel, dose-response UL movement trial. This analysis compared the accuracy and consistency between self-reported UL performance and sensor-measured UL performance at baseline and immediately post an 8-week intensive UL task-specific intervention.SettingOutpatient rehabilitation.ParticipantsCommunity-dwelling individuals with chronic (≥6mo) UL paresis poststroke (N=64).InterventionsNot applicable.Main Outcome MeasuresMotor Activity Log amount of use scale and the sensor-derived use ratio from wrist-worn accelerometers.ResultsThere was a high degree of variability between self-reported UL performance and the sensor-derived use ratio. Using sensor-based values as a reference, 3 distinct categories were identified: accurate reporters (reporting difference ±0.1), overreporters (difference >0.1), and underreporters (difference <−0.1). Five of 64 participants accurately self-reported UL performance at baseline and postintervention. Over half of participants (52%) switched categories from pre-to postintervention (eg, moved from underreporting preintervention to overreporting postintervention). For the consistent reporters, no participant characteristics were found to influence whether someone over- or underreported performance compared with sensor-based assessment.ConclusionsParticipants did not consistently or accurately self-report UL performance when compared with the sensor-derived use ratio. Although self-report and sensor-based assessments are moderately associated and appear similar conceptually, these results suggest self-reported UL performance is often not consistent with sensor-measured performance and the measures cannot be used interchangeably.



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Extreme delta - with or without brushes: a potential surrogate marker of disease activity in anti-NMDA-receptor encephalitis

NMDARE is a treatable antibody-mediated neurological syndrome resulting in neuropsychiatric disturbances and seizures, which may evolve to severe encephalopathy, autonomic disturbance and orofacial dyskinesias (Dalmau et al. 2011). Clinical seizures are seen in 80% of cases (Dalmau et al. 2011) and EEG abnormalities in 90% (Titulaer et al. 2013), of which the potentially specific EEG pattern of "extreme delta brush" may carry worse prognosis (Schmitt et al. 2012) and may be associated with electrographic seizures (Veciana et al.

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Long Term Electroencephalography in Preterm Neonates: Safety and Quality of Electrode Types

Seizures in preterm neonates have been reported with an incidence ranging between 3.9%-48% (Hellstrom-Westas et al., 1985; Scher et al., 1993; Vesoulis et al., 2014; Lloyd et al., 2017). Seizure incidence varies with the EEG modality utilized- amplitude-integrated EEG (aEEG) versus conventional EEG. Early life seizures in sick premature neonates portend both poor short and long term outcomes. Seizures in extremely low birth weight neonates were associated with short term morbidities such as severe intraventricular hemorrhage, sepsis, meningitis and cystic periventricular leukomalacia (Davis et al., 2010).

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Identification of novel mutations in FFPE lung adenocarcinomas using DEPArray sorting technology and next-generation sequencing

Abstract

Formalin-fixed paraffin-embedded (FFPE) tissues are utilized as the standard diagnostic method in pathology laboratories. However, admixture of unwanted tissues and shortage of normal samples, which can be used to detect somatic mutation, are considered critical factors to accurately diagnose cancer. To explore these challenges, we sorted the pure tumor cells from 22 FFPE lung adenocarcinoma tissues via Di-Electro-Phoretic Array (DEPArray) technology, a new cell sorting technology, and analyzed the variants with next-generation sequencing (NGS) for the most accurate analysis. The allele frequencies of the all gene mutations were improved by 1.2 times in cells sorted via DEPArray (tumor suppressor genes, 1.3–10.1 times; oncogenes, 1.3–2.6 times). We identified 16 novel mutations using the sequencing from sorted cells via DEPArray technology, compared to detecting 4 novel mutation by the sequencing from unsorted cells. Using this analysis, we also revealed that five genes (TP53, EGFR, PTEN, RB1, KRAS, and CTNNB1) were somatically mutated in multiple homogeneous lung adenocarcinomas. Together, we sorted pure tumor cells from 22 FFPE lung adenocarcinomas by DEPArray technology and identified 16 novel somatic mutations. We also established the precise genomic landscape for more accurate diagnosis in 22 lung adenocarcinomas with mutations detected in pure tumor cells. The results obtained in this study could offer new avenues for the treatment and the diagnosis of squamous cell lung cancers.

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Single-center ventral hernia repair with porcine dermis collagen implant

Abstract

Introduction

This study aims to evaluate the outcomes and utilization of porcine acellular dermal collagen implant (PADCI) during VHR at a large tertiary referral center.

Methods

Records of 5485 patients who underwent VIHR from June 1995 to August 2014 were retrospectively reviewed to identify patients >18 years of age who had VIHR with PADCI reinforcement. Use of multiple mesh reinforcement products, inguinal hernias, and hiatal hernias were exclusion criteria. The primary outcome was hernia recurrence, and secondary outcomes were early complications and surgical site occurrences (SSOs). Uni- and multivariate analyses assessed risk factors for recurrence after PADCI reinforced VIHR.

Results

There were 361 patients identified (54.5% female, mean age of 56.7 ± 12.5 years, and mean body mass index (BMI) of 33.0 ± 9.9 kg/m²). Hypertension (49.5%), diabetes (24.3%), and coronary artery disease (14.4%) were the most common comorbidities, as was active smoking (20.7%). Most were classified as American Association of Anesthesiologists (ASA) Class 3 (61.7%). Hernias were distributed across all grades of the ventral hernia working group (VHWG) grading system: grade I 93 (25.7%), grade II 51 (14.1%), grade III 113 (31.3%), and grade IV 6 (1.6%). Most VIHR were performed from an open approach (96.1%), and were frequently combined with concomitant surgical procedures (47.9%). Early postoperative complications (first 30 days) were reported in 39.0%, with 71 being SSO. Of the 19.7% of patients with SSO, there were 31 who required procedural intervention. After a mean follow-up of 71.5 ± 20.5 months, hernia recurrence was documented in 34.9% of patients. Age and male gender were predictors of recurrence on multivariate analysis.

Conclusion

To the best of our knowledge, this is the largest retrospective single institutional study evaluating PADCI to date. Hernias repaired with PADCI were frequently in patients undergoing concomitant operations. Reinforcement with PADCI may be considered a temporary closure, with a relatively high recurrence rate, especially among patients who are older, male, and undergo multiple explorations in a short perioperative period.

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En bloc endoscopic mucosal resection is equally effective for sessile serrated polyps and conventional adenomas

Abstract

Background

Sessile serrated polyps (SSPs) are associated with higher rates of incomplete resection compared to conventional adenomas after traditional snare polypectomy. Outcomes after endoscopic mucosal resection (EMR) are less established. The aim of this study was to evaluate the rate of residual neoplasia at surveillance colonoscopy for SSPs compared to conventional adenomas ≥ 10 mm after en bloc EMR.

Methods

Retrospective cohort study of consecutive patients referred for EMR of a colonic lesion ≥ 10 mm from 2005 to 2013. Data on procedures, histopathology, and surveillance colonoscopies were recorded. The primary outcome was rate of macroscopically evident residual neoplasia at surveillance colonoscopy for SSPs compared to adenomas. Secondary outcomes included rate of neoplasia at the resection margin.

Results

283 consecutive patients with 293 polyps underwent en bloc EMR including 101 SSPs and 192 adenomas. Pathology commented on the lateral resection margins of the specimen in 235 cases (80%). Of these, neoplasia was noted at the resection margin in 29/64 SSPs (45.3%) compared to 65/171 adenomas (38.0%; P = .37). Surveillance data were available for 153 index lesions with a median interval of 13 months (interquartile range, 10.75–23.25 months). Ten resection sites (6.5%) were found to have residual neoplasia, including 2/52 SSPs (3.8%) and 8/101 adenomas (7.9%; P = .50). Of the cases with surveillance data 128/153 (84%) commented on the lateral margin of the resection specimen. Residual neoplasia was noted in 3/68 lesions (4.4%) with negative margins compared to 5/60 lesions (8.3%) with positive margins (P = .47).

Conclusions

En bloc EMR for colonic lesions ≥ 10 mm is associated with a 6.5% rate of macroscopic residual neoplasia. Although 45% of SSPs had neoplasia extending to the resection margin, rates of residual neoplasia at surveillance colonoscopy were low. These results suggest that when feasible en bloc EMR is a reasonable option to resect SSPs ≥ 10 mm.

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Effect of language experience on selective auditory attention: An event-related potential study

Publication date: Available online 9 March 2018
Source:International Journal of Psychophysiology
Author(s): Pia Rämä, Alina Leminen, Satu Koskenoja-Vainikka, Miika Leminen, Kimmo Alho, Teija Kujala
Dual language experience has typically been shown to improve various executive control functions. We investigated with event-related brain potentials (ERPs) recorded from early (natively) bilingual speakers and control participants whether it also affects auditory selective attention. We delivered to our participants two tone streams, one to the left and one to the right ear. Both streams consisted of standard tones and two types of infrequent deviant tones which had either an enhanced duration or intensity. The participants were instructed to attend either to the right or left stream and to detect longer-duration deviants in the attended stream. The results showed that the early bilinguals did not outperform the controls in target detection accuracy or speed. However, the late portion of the attention-related ERP modulation (the negative difference, Nd) was larger over the left hemisphere in the early bilinguals than in the controls, suggesting that the maintenance of selective attention or further processing of selectively attended sounds is enhanced in the bilinguals. Moreover, the late reorienting negativity (RON) in response to intensity-deviant tones was larger in the bilinguals, suggesting more efficient disengagement of attention from distracting auditory events. Hence, our results demonstrate that brain responses associated with certain aspects of auditory attention are enhanced in the bilingual adults, indicating that early dual language exposure modulates the neuronal responsiveness of auditory modality.



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