Atypical Distributions Research Articles

Issues in the diagnosis of pneumonia in elderly patients

In elderly patients, the onset of pneumonia is often subtle and typical respiratory symptoms are less common. Instead, non-specific presentations such as altered mental status and loss of appetite should be closely monitored. The sensitivity of chest X-rays and routine laboratory tests is often low, so a comprehensive assessment including risk factors is required. The presence of multiple comorbidities, including chronic respiratory disease, cardiovascular disease, and diabetes mellitus, is prevalent in this population and complicates early diagnosis. Polypharmacy further adds to the diagnostic and therapeutic challenges. Due to difficulties in specimen collection, high risks associated with invasive testing and atypical pathogen distributions, conventional microbiological detection methods often fail to meet clinical needs. Nucleic acid testing techniques, such as metagenome next-generation sequencing, offer a rapid and sensitive alternative for detecting a wide range of pathogens, including those not identified by conventional methods, as well as rare, multiple, or mixed infections. This approach also has the advantage of not being influenced by prior antibiotic use, making it a crucial role in diagnosing pneumonia in the elderly. However, it is imperative to select appropriate and high-quality specimen types and to interpret the results accurately, taking into account the clinical context and indications for testing. Timely and precise diagnosis is essential to improve the prognosis of pneumonia in elderly patients.

Evaluation of Common and Atypical Clinical Presentations of Tinea Faciei: A Cross-sectional Study from Barabanki, Uttar Pradesh, India

Introduction: Tinea faciei is a dermatophytic infection affecting the glabrous skin of the face. While it is less common than dermatophyte infections of other anatomical sites, tinea faciei has become more prevalent in recent years, being reported in Dermatology Outpatient Departments. Aim: To enrich our understanding of tinea faciei with the intention of improving diagnostic accuracy and treatment outcomes. Materials and Methods: The present cross-sectional study was conducted in the Department of Dermatology, Venereology and Leprosy, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India, from October 2022 to October 2023. Total 75 patients with the clinical diagnosis of tinea faciei were recruited and subjected to Potassium Hydroxide (KOH) preparation for direct microscopic examination. Epidemiological data, as well as, information on exposure to systemic and oral steroids, and previous treatment was collected. Different morphologies of tinea faciei, involved site on the face, severity of itching, and additional affected body areas were also noted. Coding, data entry, clearing and compiling were done in Microsoft Excel sheets, and statistical software including Statistical Package for the Social Sciences (SPSS) software version 29.0 was used for statistical analysis. Results: The present study comprised 45 (60%) males and 30 (40%) females, with a mean age of 30.7 years. A total of 27 (36%) patients had pets at their homes, and 35 (46.6%) patients were involved in handling domestic animals. A family history was positive in 21 (28%) patients. The most common site in the face was the cheeks, affecting 45 (60%) patients, followed by areas around the eyes and nose in 26 (34.6%) patients each, the forehead in 23 (30.6%), and around the mouth and on the external ear in 22 (29.3%) patients each. The initial index lesion involving the face was found in 34 (45.3%) patients, while other sites were involved in 41 (54.6%) patients. The most common morphology included ill-defined margin, absence of scaling, the central clearing, pustular lesions, incomplete circle, psoriasiform and erosions. Steroid abuse was found in 73 (97.3%) patients, where most patients giving a history of only topical steroid usage. Conclusion: The present study offers important insights into various aspects of tinea faciei, including its occurrence, epidemiology, risk factors, and the role of steroid abuse. The authors have described various common and atypical clinical morphologies and distributions of tinea faciei and recognising these atypical signs can help clinicians diagnose the condition early and initiate timely treatment. Moreover, the present study highlights that many patients use steroids in the form of topical, oral and injection to get quick relief, which can complicate the diagnosis.

Cardiovascular autonomic reactivity and inflammatory markers in patients with chronic migraine

Background: Common headache disorders, including tension-type migraines and cluster headaches, are related to malfunctions of the autonomic nervous system (ANS). Many autonomic signs of migraines aggravate the discomfort of the episode. Understanding the function and comorbidities of migraine patients depends on tests for assessing the cardiovascular autonomic responsiveness of the ANS. Aims and Objectives: The aim and objective of this study is to evaluate the use of cardiovascular reflex testing in adults with chronic migraine and healthy controls. Investigating inflammatory markers in individuals suffering from chronic migraines and controls. Materials and Methods: Thirty healthy controls and 30 people suffering from persistent migraines were part of the research. Cardiovascular reflex tests were performed. Inflammatory markers such as tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1, and IL-10 were also evaluated. SPSS edition 21 was used for the statistical analysis. For parameters with normal and atypical distributions, the Mann–Whitney test and the unpaired t-test, respectively, were used. Results: Among 30 subjects, testing for autonomic reactivity related to chronic migraines revealed significantly lower values than those for control. Patients with chronic migraines had far more inflammatory markers, including TNF-α, IL-1, and IL-10. Conclusions: Revealing autonomic dysfunction, the group with chronic migraines had a lower parasympathetic tone and sympathoexcitation than the healthy control group. Future studies should concentrate on ANS dysfunction as a biomarker for early warning signals for drug intake and migraine control.

Dissociable Contributions of Goal-Relevant Evidence and Goal-Irrelevant Familiarity to Individual and Developmental Differences in Conflict Recognition.

Recent studies using the diffusion decision model find that performance across many cognitive control tasks can be largely attributed to a task-general efficiency of evidence accumulation (EEA) factor that reflects individuals' ability to selectively gather evidence relevant to task goals. However, estimates of EEA from an n-back "conflict recognition" paradigm in the Adolescent Brain Cognitive DevelopmentSM (ABCD) Study, a large, diverse sample of youth, appear to contradict these findings. EEA estimates from "lure" trials-which present stimuli that are familiar (i.e., presented previously) but do not meet formal criteria for being a target-show inconsistent relations with EEA estimates from other trials and display atypical v-shaped bivariate distributions, suggesting many individuals are responding based largely on stimulus familiarity rather than goal-relevant stimulus features. We present a new formal model of evidence integration in conflict recognition tasks that distinguishes individuals' EEA for goal-relevant evidence from their use of goal-irrelevant familiarity. We then investigate developmental, cognitive, and clinical correlates of these novel parameters. Parameters for EEA and goal-irrelevant familiarity-based processing showed strong correlations across levels of n-back load, suggesting they are task-general dimensions that influence individuals' performance regardless of working memory demands. Only EEA showed large, robust developmental differences in the ABCD sample and an independent age-diverse sample. EEA also exhibited higher test-retest reliability and uniquely meaningful associations with clinically relevant dimensions. These findings establish a principled modeling framework for characterizing conflict recognition mechanisms and have several broader implications for research on individual and developmental differences in cognitive control.

Bootstrap Method as a Tool for Analyzing Data with Atypical Distributions Deviating from Parametric Assumptions: Critique and Effectiveness Evaluation

In today’s research environment characterized by exponential data growth and increasing complexity, the selection of appropriate statistical tests, tailored to research objectives and data distributions, is paramount for rigorous analysis and accurate interpretation. This article explores the growing prominence of bootstrapping, an advanced statistical technique for multiple comparisons analysis, offering flexibility and customization by estimating sample distributions without assuming population distributions, thus serving as a valuable alternative to traditional methods in various data scenarios. Computer simulations were conducted using data from cardiovascular disease patients. Two approaches, spontaneous partly controlled simulation and fully constrained simulation using self-written R scripts, were utilized to generate datasets with specified distributions and analyze the data using tests for comparing more than two groups. The utilization of the bootstrap method greatly improves statistical analysis, especially in overcoming the constraints of conventional parametric tests. Our research showcased its effectiveness in comparing multiple scenarios, yielding strong findings across diverse distributions, even with minor inflation in p values. Serving as a valuable substitute for parametric approaches, bootstrap promotes careful consideration when rejecting hypotheses, thus fostering a deeper understanding of statistical nuances and bolstering analytical rigor.

Optimized Real-Time Stochastic Model of Power Electronic Converters based on FPGA

Stochastic models can effectively describe the operating characteristics of power electronic converters with stochastic parameters. However, it is difficult to implement the models in FPGA-based real-time simulation (RTS) because their high order leads to a large calculation. This paper proposes an optimized real-time stochastic modeling method for power electronic converters based on generalized polynomial chaos (gPC). Firstly, an orthogonal polynomials construction method is used based on Schmidt orthogonalization to describe stochastic variables with atypical probability distributions and provide conditions for simplifying the system model. Secondly, the method of probability space transformation is adopted to divide the system model into multiple sub-models to suppress the exponential growth of the model order while maintaining the statistical properties. This method has performed over the traditional stochastic modeling method. The proposed model is built on FPGA-based hardware-in-the-loop (HIL) experiment platform with 1us simulation step. The optimized model uses approximately 37% fewer resources than the traditional stochastic model while maintaining the same level of accuracy.

Technologies for calculating and visualizing statistics on prevalence and incidence on the example of information about polypous rhinosinusitis in the Samara region

Aim to statistically determine the distribution of chronic diseases in the chronology of observations; to show the specifics of methods for testing hypotheses in the quantitative and probabilistic prediction of the prevalence of polypous rhinosinusitis.
 Material and methods. The outpatient data for the period of 20172021 and quantitative information about the cases with polypous rhinosinusitis as main or concomitant diagnosis registered by medical organizations of 25 districts of the Samara region were used in the study.
 Results. The synthesis of the initial data statistics, which amounted to the volume of the numerical expansion of primary indicators in the following ratio: categories 15.8%, counting data 26.3%; quantitative values 21.1%; 26.7% relative incidence and prevalence data. The rest of the data is the descriptive statistics and indicators in the form of tables of correlation coefficients. For extensions of the synthesized data, distributions were evaluated and hypotheses tested using statistical criteria.
 Conclusion. The count of the number of chronic diseases is approximated by the density of atypical distributions. Approximately 58% of samples for diagnoses are not confirmed as obeying the law of distribution. In such a situation, when preparing a forecast for the transition to a time series, it is necessary to solve the problem of obtaining sequences with stationary characteristics. In machine learning, data in predictive calculations must be checked for probabilistic confirmation of the coincidence of related sample parameter distributions. The results of the forecast should be taken as a probabilistic conclusion at the level of an unrejected hypothesis.

Development, initial validation, and application of a visual read method for [18F]MK-6240 tau PET.

The positron emission tomography (PET) radiotracer [18F]MK-6240 exhibits high specificity for neurofibrillary tangles (NFTs) of tau protein in Alzheimer's disease (AD), high sensitivity to medial temporal and neocortical NFTs, and low within-brain background. Objectives were to develop and validate a reproducible, clinically relevant visual read method supporting [18F]MK-6240 use to identify and stage AD subjects versus non-AD and controls. Five expert readers used their own methods to assess 30 scans of mixed diagnosis (47% cognitively normal, 23% mild cognitive impairment, 20% AD, 10% traumatic brain injury) and provided input regarding regional and global positivity, features influencing assessment, confidence, practicality, and clinical relevance. Inter-reader agreement and concordance with quantitative values were evaluated to confirm that regions could be read reliably. Guided by input regarding clinical applicability and practicality, read classifications were defined. The readers read the scans using the new classifications, establishing by majority agreement a gold standard read for those scans. Two naïve readers were trained and read the 30-scan set, providing initial validation. Inter-rater agreement was further tested by two trained independent readers in 131 scans. One of these readers used the same method to read a full, diverse database of 1842 scans; relationships between read classification, clinical diagnosis, and amyloid status as available were assessed. Four visual read classifications were determined: no uptake, medial temporal lobe (MTL) only, MTL and neocortical uptake, and uptake outside MTL. Inter-rater kappas were 1.0 for the naïve readers gold standard scans read and 0.98 for the independent readers 131-scan read. All scans in the full database could be classified; classification frequencies were concordant with NFT histopathology literature. This four-class [18F]MK-6240 visual read method captures the presence of medial temporal signal, neocortical expansion associated with disease progression, and atypical distributions that may reflect different phenotypes. The method demonstrates excellent trainability, reproducibility, and clinical relevance supporting clinical use. A visual read method has been developed for [18F]MK-6240 tau positron emission tomography.The method is readily trainable and reproducible, with inter-rater kappas of 0.98.The read method has been applied to a diverse set of 1842 [18F]MK-6240 scans.All scans from a spectrum of disease states and acquisitions could be classified.Read classifications are consistent with histopathological neurofibrillary tangle staging literature.

Program design considerations for bone health in premenopausal women

The purpose of this literature review is to critique training studies that have examined the effects of jump-landing programmes on bone health parameters in premenopausal women. Activities such as jumping and hopping have been proposed to achieve the desired unusual or atypical strain distributions on the skeleton for women who are habitually inactive and not involved in high-impact sports, however specific protocols to optimise bone health are currently lacking. From this review, it can be concluded that jump-landing protocols that; utilise brief jumping episodes (10 - 100 jumps/day, 3 - 7 days/week), are 4 - 18 months duration, and present loading magnitudes of between 2 - 6 body weights (BW) and rates of >43 BW.sˉ¹, can result in significant gains in femoral neck bone mineral density of 0.6 – 3.4% in premenopausal women. Evidence from this review has the potential to inform future exercise recommendations used to improve bone health during the critical premenopausal period, and to both reduce and delay the incidence of osteoporotic fracture in the years post menopause.

Racial and Ethnic Disparities in Malignant Melanoma: A Literature Review

Melanoma is a tumor arising from uncontrolled proliferation of melanocytes, neural crest derived cells responsible for production of pigment in the basal layer of the epidermis. While the prevalence of melanoma is greatest in fair-skinned populations, racial and ethnic minority populations disproportionately experience lower rates of survival when diagnosed with melanoma. Recent studies indicate that, among minority populations, melanoma tends to present at a more advanced stage with more aggressive melanoma subtypes, increased and atypical distributions over the body, and increased tumor depths. Populations of color are also shown to carry unique mutations in BRCA genes that may predispose them to developing melanoma and account for increased mortality rates. Socioeconomic status has also been linked to melanoma disparities, where limited access to quality healthcare including skin exams, insurance, and education may result in decreased melanoma survival rates. The aim of this article is to review the relationship between melanoma and underserved communities as well as discuss the current explanations behind these observations.

Likelihood Ratio Processes under Nonstandard Settings

This paper establishes the LAN property for the curved normal families and the simultaneous equation systems. In addition, we show that one-way random ANOVA models fail to have the LAN property. We consider the two cases when the variance of random effect lies in the interior and boundary of parameter space. In the former case, the log-likelihood ratio converges to 0. In the latter case, the log-likelihood ratio has atypical limit distributions, which depend on the contiguity orders. The contiguity orders corresponding to the variances of random effects and disturbances can be equal to or greater than one, respectively, and that corresponding to the grand mean can be equal to or greater than one half. Consequently, we cannot use the ordinary optimal theory based on the LAN property. Meanwhile, the test based on the log-likelihood ratio is shown to be asymptotically most powerful with the benefit of the classical Neymann--Pearson framework.

Adolescent perception of family dysfunction in Serbia and Montenegro by gender and age

In this study, the authors use a specially constructed Family dysfunction Scale to examine the spread and structure of familial disorders on samples of 2803 respondents from Serbia and 1123 from Montenegro. Given that it is about a normal, non-clinical population, more than 4/5 of respondents report good or very good family relationships, while 15% of cases report disturbed family relationships. In order to examine family dysfunctionality, we subjected the 17-item scale with answers in the form of a five-point Likert-type scale, to Varimax factor analysis. The scale, which is being used for the first time, has shown excellent metric properties. Two factors stood out; the first, much stronger, which carries 55.64% of the variance and the second, much weaker, which carries 8.19% of the variance. On the first factor, 8 items were singled out with very high saturations, which provide a picture of cohesive and functional families. On the second factor, also with high saturations, six items describing weakly cohesive, emotionally disturbed and alienated families stood out. Using the T test between the samples of Serbia and Montenegro on the Scale of family dysfunction statistically significant differences were found on 8 of 17 items. In the sample from Montenegro, quarrels, physical conflicts, stressful situations, alienation and lack of understanding between family members are significantly more common. The authors find the reasons in a prolonged chronic socio-economic crisis that led to atypical distributions of family roles and authority, synergistically with some anachronistic collective-psychological patterns in Montenegrin households in the last three decades.

Isolated sensory impairment of the ear auricle in a patient with cerebral infarction localized to the postcentral gyrus

AbstractPure sensory stroke, a well‐defined clinical entity characterized by sensory symptoms, sometimes causes atypical distributions of sensory impairment. We herein report an 85‐year‐old man presenting with isolated sensory impairment of the right‐sided ear auricle due to postcentral gyrus infarction. The somatotopic representation in the human primary somatosensory cortex that corresponds to the ear has not been elucidated. This case suggests the possible cortical area for the ear.

Relative age effect? No "flipping" way! Apparatus dependent inverse relative age effects in elite, women's artistic gymnastics.

In contrast to research on team-sports, delayed maturation has been observed in higher-skilled gymnasts, leading to atypical distributions of the relative age effect. Recent studies have reported intra-sport differences in the relative age effect and given the task demands across gymnastics apparatus, we expected to find evidence for the influence of apparatus specialism. We examined the presence of a relative age effects within a sample of elite, international, women's artistic gymnasts (N = 806, Ncountries = 87), and further sampled our data from vault, bars, beam, and floor major competition finalists. Poisson regression analysis indicated no relative age effect in the full sample (p = .55; R2 adj. = .01) but an effect that manifested when analysing apparatus independently. The Index of Discrimination (ID) analysis provided evidence of an inverse relative age effect identified for beam (p = .01; ID = 1.27; R2 adj. = .12), a finding that was corroborated by a marginal effect in our vault finalists (p = .08; ID = 1.21; R2 adj. = .06). These novel findings can be attributed to the integrated influence of self-fulfilling prophecy upon coach and gymnast expectations, as well as the technical mechanisms underpinning skill development involved in the underdog hypothesis.

Identification of integrative and conjugative elements in pathogenic and commensal Neisseriaceae species via genomic distributions of DNA uptake sequence dialects.

Mobile genetic elements (MGEs) are key factors responsible for dissemination of virulence determinants and antimicrobial-resistance genes amongst pathogenic bacteria. Conjugative MGEs are notable for their high gene loads donated per transfer event, broad host ranges and phylogenetic ubiquity amongst prokaryotes, with the subclass of chromosomally inserted integrative and conjugative elements (ICEs) being particularly abundant. The focus on a small number of model systems has biased the study of ICEs towards those conferring readily selectable phenotypes to host cells, whereas the identification and characterization of integrated cryptic elements remains challenging. Even though antimicrobial resistance and horizontally acquired virulence genes are major factors aggravating neisserial infection, conjugative MGEs of Neisseria gonorrhoeae and Neisseria meningitidis remain poorly characterized. Using a phenotype-independent approach based on atypical distributions of DNA uptake sequences (DUSs) in MGEs relative to the chromosomal background, we have identified two groups of chromosomally integrated conjugative elements in Neisseria : one found almost exclusively in pathogenic species possibly deriving from the genus Kingella , the other belonging to a group of Neisseria mucosa -like commensals. The former element appears to enable transfer of traditionally gonococcal-specific loci such as the virulence-associated toxin–antitoxin system fitAB to N. meningitidis chromosomes, whilst the circular form of the latter possesses a unique attachment site (attP) sequence seemingly adapted to exploit DUS motifs as chromosomal integration sites. In addition to validating the use of DUS distributions in Neisseriaceae MGE identification, the >170 identified ICE sequences provide a valuable resource for future studies of ICE evolution and host adaptation.

Prediction of clinical and biomarker conformed Alzheimer’s disease and mild cognitive impairment from multi-feature brain structural MRI using age-correction from a large independent lifespan sample

Structural neuroimaging has been applied to the identification of individuals with Alzheimer's disease (AD) and mild cognitive impairment (MCI). However, these methods are greatly impacted by age limiting their utility for detection of preclinical pathology. We built linear models for age based on multiple combined structural features using a large independent lifespan sample of 272 healthy adults across a wide age range from the Human Connectome Project Aging study. These models were then used to create a new support vector machine (SVM) training model in 136 AD and 268 control participants based on residues of fit from the expected age-effects relationship. Subsequent validation assessed the accuracy of the SVM model in new datasets. Finally, we applied the classifier to 276 individuals with MCI to evaluate prediction for early impairment and longitudinal cognitive change. The optimal 10-fold cross-validation accuracy was 93.07%, compared to 91.83% without age detrending. In the validation dataset, the classifier for AD obtained an accuracy of 84.85% (56/66), sensitivity of 85.36% (35/41) and specificity of 84% (21/25). Classification accuracy was improved when using the lifespan sample as opposed to the classification sample. Importantly, we observed cross-sectional greater AD specific biomarkers, as well as faster cognitive decline in MCI who were classified as more 'AD-like' (MCI-AD), and these effects were pronounced in individuals who were late MCI. The top five contributive features were volumes of left hippocampus, right hippocampus, left amygdala, the thickness of left and right middle temporal & parahippocampus gyrus. Linear detrending for age in SVM for combined structural features resulted in good performance for recognition of AD and AD-specific biomarkers, as well as prediction of MCI progression. Such procedures may be used in future work to enhance prediction in samples with atypical age distributions.

Classification Consistency and Accuracy With Atypical Score Distributions

AbstractThe current study aims to evaluate the performance of three non‐IRT procedures (i.e., normal approximation, Livingston‐Lewis, and compound multinomial) for estimating classification indices when the observed score distribution shows atypical patterns: (a) bimodality, (b) structural (i.e., systematic) bumpiness, or (c) structural zeros (i.e., no frequencies). Under a bimodal distribution, the normal approximation procedure produced substantially large bias. For a distribution with structural bumpiness, the compound multinomial procedure tended to introduce larger bias. Under a distribution with structural zeroes, the relative performance of selected estimation procedures depended on cut score location and the sample‐size conditions. In general, the differences in estimation errors among the three procedures were not substantially large.

Cross-shelf Heterogeneity of Coral Assemblages in Northwest Australia

Understanding the spatial and temporal distribution of coral assemblages and the processes structuring those patterns is fundamental to managing reef assemblages. Cross-shelf marine systems exhibit pronounced and persistent gradients in environmental conditions; however, these gradients are not always reliable predictors of coral distribution or the degree of stress that corals are experiencing. This study used information from government, industry and scientific datasets spanning 1980–2017, to explore temporal trends in coral cover in the geographically complex system of the Dampier Archipelago, northwest Australia. Coral composition at 15 sites surveyed in 2017 was also modelled against environmental and spatial variables (including turbidity, degree heat weeks, wave exposure, and distance to land/mainland/isobath) to assess their relative importance in structuring coral assemblages. High spatial and temporal heterogeneity was observed in coral cover and recovery trajectories, with reefs located an intermediate distance from the shore maintaining high cover over the past 20 years. The abundance of some prominent genera in 2017 (Acropora, Porites, and Turbinaria spp.) decreased with the distance from the mainland, suggesting that inshore processes play an important role in dictating the distribution of these genera. The atypical distributions of these key reef-building corals and spatial heterogeneity of historical recovery trajectories highlight the risks in making assumptions regarding cross-shelf patterns in geographically complex systems.

Orbitofrontal sulcogyral morphology is a transdiagnostic indicator of brain dysfunction.

Atypical sulcogyral patterns in the orbitofrontal cortex (OFC) are associated with increased risk for schizophrenia, as well as with quantitative traits associated with schizophrenia, such as anhedonia. Here we conduct a cross-diagnostic comparison to assess whether atypical OFC sulcogyral patterns confer risk for multiple brain disorders. We examined structural images from 4 groups of adult participants (N = 189), including those diagnosed with schizophrenia (SZ; N = 49), bipolar disorder (BP; N = 46), attention deficit hyperactivity disorder (ADHD; N = 41), and controls (N = 53). OFC sulcogyral pattern types were determined based on the continuity of the medial and lateral orbitofrontal sulcus. Chi-square analysis was performed to compare the sulcogyral pattern frequency distributions between patient groups and controls. We find that both SZ and BP groups had atypical pattern distributions, with increased atypical pattern frequencies relative to controls in the left hemisphere, consistent with the overlapping clinical features and genetic etiology of these disorders (SZ: χ2 = 17.6; p < 0.001; BP: χ2 = 19.2, p < 0.001). The ADHD group distribution did not significantly differ from controls (χ2 = 5.5; p = 0.06, NS.). Similar sulcogyral pattern frequencies across BP and SZ suggest that the sulcogyral phenotype may map more directly to a trait that is transdiagnostic. These results suggest that sulcogyral patterns present a novel morphological indicator for increased susceptibility to multiple psychiatric diagnoses.

Top Incomes and the Measurement of Inequality in Egypt

By all accounts, income inequality in Egypt is low and had been declining during the decade that preceded the 2011 revolution. As the Egyptian revolution was partly motivated by claims of social injustice and inequalities, this seems at odds with a low level of income inequality. Moreover, while income inequality shows a decline between 2000 and 2009, the World Values Surveys indicate that the aversion to inequality has significantly increased during the same period and for all social groups. This paper utilizes a range of recently developed statistical techniques to assess the true value of income inequality in the presence of a range of possible measurement issues related to top incomes, including item and unit non-response, outliers and extreme observations, and atypical top income distributions. The analysis finds that correcting for unit non-response significantly increases the estimate of inequality by just over 1 percentage point, that the Egyptian distribution of top incomes follows rather closely the Pareto distribution, and that the inverted Pareto coefficient is located around median values when compared with 418 household surveys worldwide. Hence, income inequality in Egypt is confirmed to be low while the distribution of top incomes is not atypical compared with what Pareto had predicted and compared with other countries in the world. This would suggest that the increased frustration with income inequality voiced by Egyptians and measured by the World Values Surveys is driven by factors other than income inequality.