Continuous Measurement Research Articles

The measurement of "high-impact chronic pain": Limitations and alternative methods.

Chronic pain is known to be an important construct in clinical practice and a particular form of chronic pain, high-impact chronic pain (HICP), has gained recent interest and attention by pain clinicians, epidemiologists, and clinical researchers. The purpose of our Topical Review is to describe the historical development of measures of HICP and to explore the psychometric properties of HICP as well as to present alternative measurement methods. We identified strengths and weaknesses of the psychometric characteristics of HICP measures. Limitations of existing HICP measures were discussed and summarized and alternatives to current methods were proposed. HICP operational definitions show variability across studies. All definitions cannot be correct, but which ones are incorrect cannot be determined as there is no gold standard. Random measurement error and recall bias are among the other limitations of current HICP measures. Model-based definitions of HICP, the discrete (for epidemiologic applications) and continuous (for clinical applications) latent variable models are discussed as likely superior alternatives to current methods. Limitations of existing HICP methods are discussed and alternative development approaches to HICP measures are presented. The use of either discrete or continuous latent variable models would improve upon the psychometric characteristics of current HICP evidence. Examples are used to illustrate the benefits of latent variable models over traditional observed variable conceptualizations as the measurement of HICP continues to develop. This work takes the position that current methods of measuring high impact chronic pain (HICP) likely contain substantial error. We have endorsed an alternative approach for several psychometrically grounded reasons. We recommend that future work consider the discrete latent variable framework for dichotomous measures of HICP and the continuous latent variable framework for continuous measures of HICP. The paper provides illustrative examples of these methods for a different patient reported measure that is lacking a gold standard, much like HICP measures.

AutoRefl: active learning in neutron reflectometry for fast data acquisition

Neutron reflectometry (NR) is a powerful technique for interrogating the structure of thin films at interfaces. Because NR measurements are slow and instrument availability is limited, measurement efficiency is paramount. One approach to improving measurement efficiency is active learning (AL), in which the next measurement configurations are selected on the basis of information gained from the partial data collected so far. AutoRefl, a model-based AL algorithm for neutron reflectometry measurements, is presented in this manuscript. AutoRefl uses the existing measurements of a function to choose both the position and the duration of the next measurement. AutoRefl maximizes the information acquisition rate in specific model parameters of interest and uses the well defined signal-to-noise ratio in counting measurements to choose appropriate measurement times. Since continuous measurement is desirable for practical implementation, AutoRefl features forecasting, in which the optimal positions of multiple future measurements are predicted from existing measurements. The performance of AutoRefl is compared with that of well established best practice measurements for supported lipid bilayer samples using realistic digital twins of monochromatic and polychromatic reflectometers. AutoRefl is shown to improve NR measurement speeds in all cases significantly.

Pulmonary function in patients with adolescent idiopathic scoliosis: an explorative study of a wearable smart shirt as a measurement instrument.

Adolescent idiopathic scoliosis (AIS) presents various challenges, including respiratory symptoms that impact pulmonary function. This study aims to explore the feasibility of using a smart shirt for continuous monitoring of lung volumes and heart rate during routine activities in AIS patients. A single-center exploratory feasibility study was conducted with AIS patients aged 16-22years with a thoracic curvature of ≥ 30 degrees and absence of respiratory comorbidities. A smart shirt was utilized to continuously monitor cardiopulmonary parameters during mild exercise, which included a standardized walking route with the ascent of multiple stairs. Five participants completed the study. Baseline spirometry measurements showed a range of values for forced vital capacity (FVC), forced expiratory volume in 1s (FEV1), and FEV1/FVC ratio. During mild exercise, participants exhibited variability in tidal volume, heart rate, breathing rate, and minute ventilation, with increases observed during stair climbing. Breathlessness levels also varied throughout the activity but did not correlate with the measured lung volumes. Overall, the use of the smart shirt for assessing pulmonary function in AIS patients was deemed feasible and well tolerated by participants during the test activities. The study confirms the feasibility of using a smart shirt for continuous measurement of cardiopulmonary parameters in AIS patients during daily activities. Incongruities between spirometry results and perceived dyspnea exists, which questions the nature of the perceived dyspnea. Further research is needed to validate these findings and explore the impact of AIS characteristics on measurement accuracy.

Oxygen saturation recovery after 6-minute walk test in patients with idiopathic pulmonary fibrosis

BackgroundThe six-minute walk test (6MWT) is widely used to assess functional capacity and prognosis in patients with idiopathic pulmonary fibrosis (IPF). However, studies on oxygen saturation recovery after the 6MWT in patients with IPF are rare. In our study, we investigated the relationship between oxygen saturation recovery time and dyspnea, fatigue, quality of life, prognostic markers and pulmonary hypertension (PH).MethodsIn this cross-sectional study, IPF patients diagnosed according to current guidelines and followed up in our Interstitial Lung Disease Outpatient Clinic between 2021 and 2022 were included. Demographics, data from spirometry, diffusion capacity measurement, arterial blood gas analysis, transthoracic echocardiography and the 6MWT were recorded. The oxygen saturation recovery time, distance saturation product (DSP), gender-age-physiology (GAP) index and composite physiological index (CPI) scores were calculated. Dyspnea severity was assessed by the modified Medical Research Council (mMRC) and Dyspnoea-12 (D-12) scales, fatigue severity by the Multidimensional Fatigue Inventory (MFI-20) and quality of life by the St George’s Respiratory Questionnaire (SGRQ).ResultsFifty IPF patients (34 men, 16 women, age: 66.8 ± 7.3 years) were included in the study. The mean FVC was 77.8 ± 19.3%, the DLCO was 52.9 ± 17.1%, the 6-minute walk distance (6MWD) was 385.7 ± 90.6 m, the GAP index was 3.5 ± 1.5, and the CPI was 43.7 ± 14.1. Oxygen saturation after the 6MWT reached pretest values at an average of 135.6 ± 73.5 s. The oxygen saturation recovery time was longer in patients with higher GAP index scores (Rs = 0.870, p < 0.001), CPI scores (Rs = 0.906, p < 0.001), desaturation (Rs = 0.801, p < 0.001), FVC%/DLCO% (Rs = 0.432, p = 0.002), sPAP (Rs = 0.492, p = 0.001), TRV (Rs = 0.504, p = 0.001), mMRC (Rs = 0.913, p < 0.001), MFI-20 (Rs = 0.944, p < 0.001), D-12 scale (Rs = 0.915, p < 0.001) and SGRQ scores (Rs = 0.927, p < 0.001); lower FVC (%) (Rs=-0.627, p < 0.001), DLCO (%) (Rs=-0.892, p < 0.001), PaO2 (Rs=-0.779, p < 0.001), DSP (Rs=-0.835, p < 0.001), and 6MWD (Rs=-0.763, p < 0.001). A total of twenty patients (40%) exhibited an increased risk of PH. According to our multiple regression analysis, oxygen saturation recovery time was independently associated with the GAP index (p = 0.036), the lowest oxygen saturation occurring during the 6MWT (p = 0.011) and the SGRQ score (p < 0.001).ConclusionsOur results showed that oxygen saturation recovery time is associated with dyspnea, fatigue, quality of life, increased risk of PH and prognostic markers in IPF. Therefore, we recommend continuous measurement of oxygen saturation after 6MWT until pretest values are reached.

An ontology-based tool for modeling and documenting events in neurosurgery

BackgroundIntraoperative neurophysiological monitoring (IOM) plays a pivotal role in enhancing patient safety during neurosurgical procedures. This vital technique involves the continuous measurement of evoked potentials to provide early warnings and ensure the preservation of critical neural structures. One of the primary challenges has been the effective documentation of IOM events with semantically enriched characterizations. This study aimed to address this challenge by developing an ontology-based tool.MethodsWe structured the development of the IOM Documentation Ontology (IOMDO) and the associated tool into three distinct phases. The initial phase focused on the ontology’s creation, drawing from the OBO (Open Biological and Biomedical Ontology) principles. The subsequent phase involved agile software development, a flexible approach to encapsulate the diverse requirements and swiftly produce a prototype. The last phase entailed practical evaluation within real-world documentation settings. This crucial stage enabled us to gather firsthand insights, assessing the tool’s functionality and efficacy. The observations made during this phase formed the basis for essential adjustments to ensure the tool’s productive utilization.ResultsThe core entities of the ontology revolve around central aspects of IOM, including measurements characterized by timestamp, type, values, and location. Concepts and terms of several ontologies were integrated into IOMDO, e.g., the Foundation Model of Anatomy (FMA), the Human Phenotype Ontology (HPO) and the ontology for surgical process models (OntoSPM) related to general surgical terms. The software tool developed for extending the ontology and the associated knowledge base was built with JavaFX for the user-friendly frontend and Apache Jena for the robust backend. The tool’s evaluation involved test users who unanimously found the interface accessible and usable, even for those without extensive technical expertise.ConclusionsThrough the establishment of a structured and standardized framework for characterizing IOM events, our ontology-based tool holds the potential to enhance the quality of documentation, benefiting patient care by improving the foundation for informed decision-making. Furthermore, researchers can leverage the semantically enriched data to identify trends, patterns, and areas for surgical practice enhancement. To optimize documentation through ontology-based approaches, it’s crucial to address potential modeling issues that are associated with the Ontology of Adverse Events.

Thermal Behaviour of Cool-Pavement Materials Development using Palm Oil Shell Aggregate

Cool-pavement technology has emerged as a potential solution to environmental issues posed by the urban heat island phenomenon, with surface temperature acting as a vital parameter in the evaluation of its thermal performance. This study focuses on the thermal performance results of modified asphalt concrete mix, wherein palm oil shell (POS) serves as a replacement for fine aggregate. Modified asphalt samples prepared using the Marshall Mix Design, with varying degrees of fine aggregate substitution (0%, 10%, 20%, 30%, 40%, and 50%), underwent a 24-hour continuous surface temperature measurement over a span of 20 days, under real-world tropical climate conditions. The findings demonstrated that sample P5, comprising 50% fine aggregate substitution, exhibited the highest reduction in surface temperature when compared to control sample P0, registering a significant decrease of up to 3.29°C during the period of peak solar intensity. ANOVA test-based statistical analyses confirmed significantly lower temperatures for all test samples, barring sample P1 (10% aggregate replacement), relative to the control sample. The results highlight the efficacy of POS as a fine aggregate substitute in asphalt concrete, significantly lowering asphalt pavement surface temperature, thereby endorsing the potential use of POS-modified asphalt in cool-pavement applications.

The energy-limited water loss of an alpine shrubland on the northeastern Qinghai-Tibetan Plateau, China

Study regionAlpine shrubland on the northeastern Qinghai-Tibetan Plateau. Study focusWater provision ability is a pivotal ecological service of high-altitude alpine regions and is controlled by precipitation, evapotranspiration (ET), and soil water storage whereas the underlying ecohydrological processes remain highly unquantified. Here, we investigated continuous 19-year flux measurements to quantify the temporal patterns of ET and water budget (precipitation minus ET, P−ET), as well as 0-20 cm soil water storage change (ΔSWS). New hydrological insights for the regionAt a monthly scale, ET peaked in July (96.7 ± 26.4 mm, Mean ± S.D.) and averaged 41.7 ± 31.9 mm, whose variations were determined by the slope of the saturation vapor pressure curve at air temperature, air and soil temperatures, regardless of vegetation growth stage. P−ET averaged 18.3 ± 26.3 mm in August and September while stayed deficit during the other months. The variations in P−ET were controlled by precipitation in the May-October growing season whereas by ET in the non-growing season from November to April. ΔSWS peaked in May (28.8 ± 11.2 mm) and September (3.0 ± 2.7 mm) and almost accumulated to zero over the whole season. At annual scales, none of ET, P−ET, and ΔSWS changed significantly. ET averaged 512.2 ± 68.4 mm and exceeded precipitation (459.1 ± 58.4 mm), likely due to the lateral flow supply of uphill locations. The variations in ET were regulated directly by bulk canopy resistance and indirectly by net radiation. P−ET averaged −53.2 ± 95.4 mm and demonstrated a clear water deficit (−51.6 ± 21.0 mm) during the non-growing season. The variations of P−ET were driven jointly by precipitation and ET, with opposite but equivalent effects. The dominance of thermal conditions and energy availability on ET variability manifested an energy-limited feature of water loss in the alpine shrubland. The temporal patterns in P−ET elucidated that the alpine shrubland plays the water retention rather than water provision function through transforming variable precipitation input into stable ET loss.

Time-Dependent Extension of Grimme's Continuous Chirality Measure for Electronic Chirality Flips in Femto- and Attosecond Time Domains.

Grimme's Continuous Chirality Measure ( ) was developed for comparisons of the chirality of the electronic wave functions of molecules, typically in their ground states. For example, , and for alanine, hydrogen-peroxide, and for achiral molecules, respectively. Well-designed laser pulses can excite achiral molecules from the electronic ground state to time-dependent chiral superposition states, with chirality flips in the femto- or even attosecond (fs or as) time domains. Here we provide a time-dependent extension of Grimme's for trailing the electronic chirality flips. As examples, we consider two laser driven electronic wavefunctions which represent flips between opposite electronic enantiomers of oriented NaK within and . The corresponding vary respectively from or from to , and back.

Recent Advances in Flexible Temperature Sensors: Materials, Mechanism, Fabrication, and Applications.

Flexible electronics is an emerging and cutting-edge technology which is considered as the building blocks of the next generation micro-nano electronics. Flexible electronics integrate both active and passive functions in devices, driving rapid developments in healthcare, the Internet of Things (IoT), and industrial fields. Among them, flexible temperature sensors, which can be directly attached to human skin or curved surfaces of objects for continuous and stable temperature measurement, have attracted much attention for applications in disease prediction, health monitoring, robotic signal sensing, and curved surface temperature measurement. Preparing flexible temperature sensors with high sensitivity, fast response, wide temperature measurement interval, high flexibility, stretchability, low cost, high reliability, and stability has become a research target. This article reviewed the latest development of flexible temperature sensors and mainly discusses the sensitive materials, working mechanism, preparation process, and the applications of flexible temperature sensors. Finally, conclusions based on the latest developments, and the challenges and prospects for research in this field are presented.

Subjective cognitive decline and objective cognitive performance in older adults: A systematic review of longitudinal and cross-sectional studies.

Older adults with subjective cognitive decline (SCD) have a higher risk of developing future cognitive decline than those without SCD. However, the association between SCD and objective cognitive performance remains unclear. This PRISMA 2020-compliant systematic review aims to provide a qualitative assessment of the longitudinal and cross-sectional relationship between SCD and objective cognitive performance in different cognitive domains, in neuropsychologically healthy, community-dwelling older adults (average age of 55 or older). To identify pertinent studies, a comprehensive search was conducted from seven databases. The National Heart, Lung and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the quality of included studies. Inclusion criteria were met by 167 studies, which were full-text and published between 1 January 1982 and 16 May 2023 (inclusive) in the languages of English, French, or Spanish and presenting data on objective cognitive performance in older adults with SCD. Overall, we found that SCD was associated with poorer objective cognitive performance on measures of global cognition and memory longitudinally compared to non-SCD status, but this association was inconsistent in cross-sectional studies. This association became stronger with the use of continuous measures of SCD as opposed to dichotomous measures. Additionally, results highlight the known lack of consistency in SCD assessment among studies and comparatively small number of longitudinal studies in SCD research.

A Novel Implantable Piezoresistive Microsensor for Intraocular Pressure Measurement.

Glaucoma is the world's second-leading irreversible eye disease causing blindness. Although the pathogenesis of glaucoma is not particularly well understood, high intraocular pressure (IOP) is widely recognized as a significant risk factor. In clinical practice, various devices have been used to measure IOP, but most of them cannot provide continuous measurements for a long time. To meet the needs of glaucoma patients who experience frequent fluctuations in the IOP and require constant monitoring, we fabricated an implantable piezoresistive IOP sensor based on microfluidic technology. The sensor has a sensitivity of 0.00257 Ω/mbar and demonstrates excellent linearity, stability, and repeatability. According to the calibration data, the average measurement error is ±0.5 mbar. We implanted it into the vitreous of a rabbit and successfully detected its IOP fluctuations. The sensor is simple in design, easy to fabricate, and can be used for long-term continuous IOP measurements. It presents a new approach for microfluidic-based IOP sensors and offers a novel method for the daily care of patients with glaucoma.

Effectiveness of Air Filtration in Reducing PM2.5 Exposures at a School in a Community Heavily Impacted by Air Pollution

Reducing children’s exposure to air pollution is a priority among California communities heavily impacted by air pollution exposures. We conducted an observational air quality study at a school to investigate the effectiveness of improved Heating, Ventilation, and Cooling (HVAC) system filters and portable air cleaners (PACs) in reducing children’s exposure to fine particulate matter (PM2.5) under real-world classroom conditions. This study included five classrooms, three of which had PACs. Halfway through the study period, high-efficiency HVAC filters were installed in all five classrooms. Continuous measurements of outdoor and in-classroom PM2.5 concentrations were used to evaluate filtration effectiveness. The air filtration strategies, alone and in combination, demonstrated 14–56% reductions in indoor PM2.5 concentrations compared to outdoor levels. There were significant improvements in filtration resulting from HVAC filter upgrades in the two classrooms without PACs (11% and 22% improvement, p &lt; 0.001). Upgrading HVAC filters in classrooms with PACs did not significantly improve filtration effectiveness, suggesting that utilizing both strategies simultaneously may not meaningfully improve air quality under these circumstances. CO2 data, as a proxy for ventilation, helped demonstrate that the observed filtration effectiveness was likely impacted by the variable HVAC system use and open doors.

Comparison of continuous temperature measurement methods in the intensive care unit: standard bladder catheter measurements versus non-invasive transcutaneous sensors.

The purpose of this study was to compare a wearable system for body core temperature measurement versus bladder and tympanic thermometers in an intensive care setting. The question was, if continuous non-invasive sensors in the intensive care unit represent an alternative to current standard methods of invasive continuous bladder temperature measurement methods?Between May and September 2023, a comparative investigation involving 112 patients was conducted in a 20-bed surgical intensive care unit to assess various temperature probes, including those placed in the tympanic tube, bladder, and skin. To achieve this, a wireless non-invasive sensor system provided by greenTEG AG, Switzerland, was affixed to different body locations (clavicular and lateral chest) of each catheterized patient (equipped with a temperature probe) admitted to the intensive care unit. Furthermore, tympanic temperatures were recorded at specified intervals. The measurement duration ranged from a minimum of six hours to a maximum of six days, resulting in the analysis of a total of 355 simultaneous temperature measurements.In this study, a wearable temperature measurement system attached to two different body sites revealed a consistent negative bias compared to bladder temperature. In addition, the measurements were particularly influenced by body constitution. The tested system in all patients showed a mean absolute error (MAE) of 0.45°C for the lateral chest and 0.50°C for the clavicular position. Tympanic measurements had a mean absolute error of 0.35°C. In patients with body mass index (BMI) ≥ 25 the MAE increased to 0.5°C for the lateral chest and 0.56°C for the clavicular position. In contrast, the tympanic measurement had a reduced MAE of 0.32°C, which is well below this threshold when compared to bladder measurements.In conclusion the investigated system did not meet the clinically relevant acceptance criteria and showed low precision in correctly identifying fever episodes compared to invasive temperature probes, however its main advantage lies in its continuity and non-invasiveness. This makes it a potential alternative to intermittent tympanic measurement devices. In this study we were able to show, that in at least one subset of patients, the non-invasive and continuous device demonstrated a precision comparable to tympanic measurements.The accuracy of all non-invasive methods was lower than in previous studies, suggesting that the use of bladder temperature as reference and user related variations may have introduced additional errors.

Compressing continuous variable quantum measurements

We generalize the notion of joint measurability to continuous variable systems by extending a recently introduced compression algorithm of quantum measurements to this realm. The extension results in a property that asks for the minimal dimensional quantum system required for representing a given set of quantum measurements. To illustrate the concept, we show that the canonical pair of position and momentum is completely incompressible. We translate the concept of measurement compression to the realm of quantum correlations, where it results in a generalization of continuous variable quantum steering. In contrast to the steering scenario, which detects entanglement, the generalization detects the dimensionality of entanglement. We illustrate the bridge between the concepts by showing that an analogue of the original EPR argument is genuinely infinite-dimensional with respect to our figure of merit, and that a fundamental discrete variable result on preparability of unsteerable state assemblages with separable states does not directly carry over to the continuous variable setting. We further prove a representation result for partially entanglement breaking channels that can be of independent interest.

High resolution identification and quantification of diffuse deep groundwater discharge in mountain rivers using continuous boat-mounted helium measurements

Discharge of deeply sourced groundwater to streams is difficult to locate and quantify, particularly where both discrete and diffuse discharge points exist, but diffuse discharge is one of the primary controls on solute budgets in mountainous watersheds. The noble gas helium is a unique identifier of deep groundwater discharge because groundwater with long residence times is commonly enriched in helium. In this study, a portable mass spectrometer was used to measure longitudinal variation in dissolved helium concentrations in two mountainous rivers at high spatial resolution not feasible with traditional sampling techniques. Helium profiles were then simulated using a mass-balance model to quantify longitudinal variation in groundwater discharge to the receiving rivers. Results indicate helium concentrations were enriched by multiple orders of magnitude above atmospheric equilibrium in both rivers and that this persisted for up to 18 km below observed pulse inputs in the Colorado River. Helium mass-balance models match observed longitudinal patterns with the exception of sharp initial increases in helium observed in the rivers. Increased longitudinal groundwater discharge rates correspond to mapped geologic structures in both watersheds that likely transport deep geothermal water. Models show variable sensitivity to spatial assignment of input variables representing the groundwater source, illustrating the importance of collecting data from discrete groundwater discharges where possible. The methodology shows promise for field experiments designed to assess air–water exchange rates and to quantify total groundwater discharge from a combination of discrete and diffuse sources.

The Wasserstein Metric between a Discrete Probability Measure and a Continuous One

This paper examines the Wasserstein metric between the empirical probability measure of n discrete random variables and a continuous uniform measure in the d-dimensional ball, providing an asymptotic estimation of their expectations as n approaches infinity. Furthermore, we investigate this problem within a mixed process framework, where n discrete random variables are generated by the Poisson process.

Does surgical sequencing influence the accuracy of maxillary positioning in bimaxillary cleft orthognathic surgery?

To evaluate whether the sequence of osteotomies influences the accuracy of maxillary positioning in patients with cleft palate ± cleft lip undergoing bimaxillary orthognathic surgery (OGS). This was a prospective study of patients with Veau 2-4 clefts who underwent bimaxillary OGS at tertiary-care children's hospital over a 3-year period. The primary predictor variable was the sequence of osteotomies (maxilla-first versus mandible-first). The primary outcome of interest was the concordance between the planned and achieved maxillary position, as assessed using linear and angular measurements. Secondary study predictors were demographic and surgical variables. Differences between groups were compared using non-parametric independent samples tests for continuous measures (data reported as median and interquartile range, IQR) and chi-squared tests for categorical measures. For all analyses, p≤ 0.05 was considered significant. Subjects who underwent maxilla-first (n=15) and mandible-first (n=16) operations were comparable with regard to age, gender, cleft type, skeletal classification, segmental maxillary osteotomy, and magnitude of maxillary movement (p ≥ 0.09). The planned sagittal and vertical positions of the maxilla were similarly accurate between the two groups (p ≥ 0.68). Angular accuracy was also comparable (p ≥ 0.56) between the study groups. In patients with CP ± CL undergoing bimaxillary orthognathic surgery, use of mandible-first sequencing, when compared to maxilla-first sequencing, does not impact accuracy of maxillary positioning in the immediate post-operative period in well-selected patients.

Application of Digital Tools and Artificial Intelligence to the Myasthenia Gravis Core Examination.

Advances in video image analysis and artificial intelligence provide the opportunity to transform the approach to patient evaluation through objective digital evaluation. We assessed ability to quantitate Zoom video recordings of a standardized neurological examination the myasthenia gravis core examination (MG-CE), which had been designed for telemedicine evaluations. We used Zoom (Zoom Video Communications) videos of patients with myasthenia gravis undergoing the MG-CE. Computer vision in combination with artificial intelligence methods were used to build algorithms to analyze videos with a focus on eye or body motions. For the assessment of examinations involving vocalization, signal processing methods were developed, including natural language processing. A series of algorithms were built that could automatically compute the metrics of the MG-CE. Fifty-one patients with MG with videos recorded twice on separate days and 15 control subjects were assessed once. We were successful in quantitating lid, eye, and arm positions and as well as well as develop respiratory metrics using breath counts. Cheek puff exercise was found to be of limited value for quantitation. Technical limitations included variations in illumination, bandwidth, and recording being done on the examiner side, not the patient. Several aspects of the MG-CE can be quantitated to produce continuous measures via standard Zoom video recordings. Further development of the technology offer the ability for trained, non-physician, health care providers to perform precise examination of patients with MG outside the clinic, including for clinical trials. Advances in video image analysis and artificial intelligence provide the opportunity to transform the approach to patient evaluation. Here, we asked whether video recordings of the typical telemedicine examination for the patient with myasthenia gravis be used to quantitate examination findings? Despite recordings not made for purpose, we were able to develop and apply computer vision and artificial intelligence to Zoom recorded videos to successfully quantitate eye muscle, facial muscle, and limb fatigue. The analysis also pointed out limitations of human assessments of bulbar and respiratory assessments. The neuromuscular examination can be enhanced by advance technologies, which have the promise to improve clinical trial outcome measures as well as standard care.

House dust metagenome and pulmonary function in a US farming population

BackgroundChronic exposure to microorganisms inside homes can impact respiratory health. Few studies have used advanced sequencing methods to examine adult respiratory outcomes, especially continuous measures. We aimed to identify metagenomic profiles in house dust related to the quantitative traits of pulmonary function and airway inflammation in adults. Microbial communities, 1264 species (389 genera), in vacuumed bedroom dust from 779 homes in a US cohort were characterized by whole metagenome shotgun sequencing. We examined two overall microbial diversity measures: richness (the number of individual microbial species) and Shannon index (reflecting both richness and relative abundance). To identify specific differentially abundant genera, we applied the Lasso estimator with high-dimensional inference methods, a novel framework for analyzing microbiome data in relation to continuous traits after accounting for all taxa examined together.ResultsPulmonary function measures (forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio) were not associated with overall dust microbial diversity. However, many individual microbial genera were differentially abundant (p-value < 0.05 controlling for all other microbial taxa examined) in relation to FEV1, FVC, or FEV1/FVC. Similarly, fractional exhaled nitric oxide (FeNO), a marker of airway inflammation, was unrelated to overall microbial diversity but associated with differential abundance for many individual genera. Several genera, including Limosilactobacillus, were associated with a pulmonary function measure and FeNO, while others, including Moraxella to FEV1/FVC and Stenotrophomonas to FeNO, were associated with a single trait.ConclusionsUsing state-of-the-art metagenomic sequencing, we identified specific microorganisms in indoor dust related to pulmonary function and airway inflammation. Some were previously associated with respiratory conditions; others were novel, suggesting specific environmental microbial components contribute to various respiratory outcomes. The methods used are applicable to studying microbiome in relation to other continuous outcomes.3hzq1LfdnyTZVYvBm7QT8RVideo

Evaluation of Point Group Symmetry in Lanthanide(III) Complexes: A New Implementation of a Continuous Symmetry Operation Measure with Autonomous Assignment of the Principal Axis.

The structure of molecular systems dictates the physical properties, and symmetry is the determining factor for all electronic properties. This makes group theory a powerful tool in quantum mechanics to compute molecular properties. For inorganic compounds, the coordination geometry has been estimated as idealized polyhedra with high symmetry, which, through ligand field theory, provides predictive capabilities. However, real samples rarely have ideal symmetry, and although continuous shape measures (CShM) can be used to evaluate deviation from an ideal reference structure σideal, this often fails for lanthanide(III) complexes with high coordination numbers, no obvious choice of principal axes, and no obvious reference structure. In lanthanide complexes, the unique electronic structures and associated properties are intricately tied to the symmetry around the lanthanide center. Therefore, robust methodologies to evaluate and estimate point group symmetry are instrumental for building structure-property relationships. Here, we have demonstrated an algorithmic approach that orients a molecular structure Q in the best possible way to the symmetry axis of any given point group G and computes a deviation from the ideal symmetry σsym(G,Q). This approach does not compute the deviation from an ideal reference system, but the intrinsic deviation in the structure induced by symmetry operations. If the structure contains the symmetry operation, there is no deviation and σsym(G,Q) = 0. The σsym deviation is generated from all of the symmetry operation ÔS in a point group G using the most correct orientation of the sample structure in each group G. The best orientation is found by an algorithm that minimizes the orientation of the structure with respect to G. To demonstrate the methodology, we have investigated the structure and symmetry of 8- and 9-coordinated lanthanide(III) aqua complexes and correlated the luminescence from 3 europium(III) crystals to their actual symmetry. To document the methodology, the approach has been tested on 26 molecules with different symmetries. It was concluded that the method is robust and fully autonomous.